Utility of proactive infliximab levels in paediatric Crohn’s disease

Burgess, Christopher; Reilly, Claire; Steward-Harrison, Lana; Balouch, Fariha; Lewindon, Peter

doi:10.1136/archdischild-2018-315100

Cited by 13 publications

(14 citation statements)

References 23 publications

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“…Median IFX serum levels during induction phase (of infusion at week 0, 2, and 6) were reported in several studies at different timepoints and levels ranged from 19.3 mg/mL (week 2), 10.9 to 14.5 mg/mL (week 6), 17.6 mg/mL (weeks 2 and 6 combined), 27 to 29 mg/mL (week 8), 16.80 mg/mL (week 10), and 5.9 mg/mL (weeks [11][12][13][14], with 5 mg/kg dosing (20,(25)(26)(27)30,41,43,49).…”

Section: Pharmacokinetics Induction Phasementioning

confidence: 99%

Pharmacokinetics, Pharmacodynamics, and Immunogenicity of Infliximab in Pediatric Inflammatory Bowel Disease

Winter

Joosse

Taminiau

et al. 2020

J. pediatr. gastroenterol. nutr.

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Objectives: Infliximab (IFX), a monoclonal antibody directed against tumor necrosis factor alpha is a potent treatment option for inflammatory bowel disease (IBD). Dosing regimens in children are extrapolated from adult data using a fixed, weight-based dose, which is often not adequate. While clinical trials have focused on safety and efficacy, there is limited data on pharmacokinetic characteristics and immunogenicity of IFX in children. The objective was to provide a systematic overview of current literature on pharmacokinetic and immunogenicity of IFX in children with IBD, to assess the validity of current adult to pediatric dosing extrapolation. Methods: A literature search identified publications up to October 2018. Eligibility criteria were study population consisting of children and/or adolescents with IBD, report of IFX trough levels and/or antibodies-to IFX, full text article or abstract, article in English, and original data. Results: Initial electronic search yielded 2360 potentially relevant articles, with 1831 remaining after removal of duplicates. An additional search yielded another 202 potentially relevant articles. Of the 2033 retrieved articles, 2000 articles were excluded based on title, abstract, or eligibility criteria. Clearance of IFX was increased in young children and children with extensive disease, leading to lower trough levels after extrapolated dosing of 5 mg/kg, antibodies-to IFX emergence, and subsequent reduced efficacy. Conclusions: Adult to pediatric weight-based dosing extrapolation is often inadequate. We provide several considerations for optimal dosing of IFX in children and adolescents with IBD.

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Section: Pharmacokinetics Induction Phasementioning

confidence: 99%

Pharmacokinetics, Pharmacodynamics, and Immunogenicity of Infliximab in Pediatric Inflammatory Bowel Disease

Winter

Joosse

Taminiau

et al. 2020

J. pediatr. gastroenterol. nutr.

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“…To address these issues, virtual machine blend has been considered as a compartment squeezing issue in specific investigates, e.g., [3,17,19]. Then again, there are explores where VM union has been separated in discrete issues where receptacle pressing arrangement considered as one of the sub-issues of VM associations, i.e., virtual machine circumstance [1,2,4,8,9,12,15,16]. There are several virtual machine allocation approaches are existed, namely Random Selection, Round Robin, Active monitor Min-min algorithms.…”

Section: Problem Definitionmentioning

confidence: 99%

“…To meet quickly developing necessities clients, another amazing Cloud Computing [1] configuration has risen, where clients could raise and get data and administrations progressively through the system. With the exceedingly request of Cloud Services unendingly expanding, receiving an adaptable, adaptable, versatile and random plan of the cloud, ready to meet the jumbled requesting of the snazzy time of overall data, has transformed into a certifiable test for Data Center structures.…”

Section: Introductionmentioning

confidence: 99%

Optimization Load Balancing Over an Imbalance Datacenter Topologies

Tharun*¹,

Kottilingam²

2019

IJRTE

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The quick demand of cloud resources, responsible for design a highly dynamic and flexible Cloud, has become a main challenge in datacenter deployment.A huge number of virtual machines will be available in Datacenter. Further Datacenter will be divided into a greater number of clusters. Each cluster is grouped to same type of Virtual machines. The virtual machines inside the cluster is homogeneous and heterogeneous to other cluster. Any virtual machine can be allocated to end user. If an unhealthy and less energy virtual machine is allocated to user, it will completely degrade the performance of the machine. To overcome this issue, we use an efficient load-balancing algorithm to allocate virtual machine to end user. The Fuzzy Optimized load-balancing algorithm uses the bandwidth, memory, CPU utilization are the key metrics. An efficient algorithm increases the number of hosts allocated to each end user

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“…T herapeutic drug monitoring (TDM) is revolutionising the way we use biologic therapies within inflammatory bowel disease (IBD) allowing both dose optimisation and the personalisation of treatment to individual patient needs. Although the majority of teams would measure reactive levels at the point of loss of response, common clinical practice now is established by studies, which support the proactive measurement of infliximab (IFX) trough levels at week 14 following a standardised infliximab induction regime (weeks 0, 2, and 6 with 8-weekly maintenance) (1,2).…”

mentioning

confidence: 99%