Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data.
Infliximab (IFX) therapy has considerably improved the treatment of rheumatoid arthritis (RA). However, some patients still do not respond adequately to IFX therapy, or the efficacy of the treatment diminishes over time. Although previous studies have reported a relationship between serum IFX levels...
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2021
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oai:doaj.org-article:92632b552d964cf2aa8dc1bb174b66c42021-12-02T20:16:58ZPotential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data.1932-620310.1371/journal.pone.0258601https://doaj.org/article/92632b552d964cf2aa8dc1bb174b66c42021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258601https://doaj.org/toc/1932-6203Infliximab (IFX) therapy has considerably improved the treatment of rheumatoid arthritis (RA). However, some patients still do not respond adequately to IFX therapy, or the efficacy of the treatment diminishes over time. Although previous studies have reported a relationship between serum IFX levels and therapeutic efficacy, the potential applications of IFX therapeutic drug monitoring (TDM) in clinical practice remain unclear. The purpose of this study was to investigate the potential applications of IFX TDM by analyzing a Japanese cohort database. Data were collected retrospectively from the Kyoto University Rheumatoid Arthritis Management Alliance cohort between January 1, 2011, and December 31, 2018. Serum IFX levels were measured using a liquid chromatography-tandem mass spectrometer. Out of the 311 RA patients that used IFX, 41 were eligible for the analysis. Serum IFX levels were significantly higher in responders than in non-responders. An optimal cut-off value was determined to be 0.32 μg/mL based on a receiver operating characteristic curve. At the IFX measurement point, a better therapeutic response was observed in the high IFX group (n = 32) than in the low IFX group (n = 9). Conversely, at the maximum effect point, when DAS28-ESR was the lowest between IFX introduction and measurement points, there were no differences in responder proportions between the low and high IFX groups. IFX primary ineffectiveness could be avoided with appropriate dose escalation without blood concentration measurement in clinical practice. In conclusion, IFX TDM could facilitate the identification of secondary non-responders and in turn, proper IFX use.Kazuto NakaeSho MasuiAtsushi YonezawaMotomu HashimotoRyu WatanabeKoichi MurataKosaku MurakamiMasao TanakaHiromu ItoKotoko YokoyamaNoriko IwamotoTakashi ShimadaMiyuki NakamuraMasaya DendaKotaro ItoharaShunsaku NakagawaYasuaki IkemiSatoshi ImaiTakayuki NakagawaMakoto HayakariKazuo MatsubaraPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258601 (2021) |
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Medicine R Science Q |
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Medicine R Science Q Kazuto Nakae Sho Masui Atsushi Yonezawa Motomu Hashimoto Ryu Watanabe Koichi Murata Kosaku Murakami Masao Tanaka Hiromu Ito Kotoko Yokoyama Noriko Iwamoto Takashi Shimada Miyuki Nakamura Masaya Denda Kotaro Itohara Shunsaku Nakagawa Yasuaki Ikemi Satoshi Imai Takayuki Nakagawa Makoto Hayakari Kazuo Matsubara Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data. |
| description |
Infliximab (IFX) therapy has considerably improved the treatment of rheumatoid arthritis (RA). However, some patients still do not respond adequately to IFX therapy, or the efficacy of the treatment diminishes over time. Although previous studies have reported a relationship between serum IFX levels and therapeutic efficacy, the potential applications of IFX therapeutic drug monitoring (TDM) in clinical practice remain unclear. The purpose of this study was to investigate the potential applications of IFX TDM by analyzing a Japanese cohort database. Data were collected retrospectively from the Kyoto University Rheumatoid Arthritis Management Alliance cohort between January 1, 2011, and December 31, 2018. Serum IFX levels were measured using a liquid chromatography-tandem mass spectrometer. Out of the 311 RA patients that used IFX, 41 were eligible for the analysis. Serum IFX levels were significantly higher in responders than in non-responders. An optimal cut-off value was determined to be 0.32 μg/mL based on a receiver operating characteristic curve. At the IFX measurement point, a better therapeutic response was observed in the high IFX group (n = 32) than in the low IFX group (n = 9). Conversely, at the maximum effect point, when DAS28-ESR was the lowest between IFX introduction and measurement points, there were no differences in responder proportions between the low and high IFX groups. IFX primary ineffectiveness could be avoided with appropriate dose escalation without blood concentration measurement in clinical practice. In conclusion, IFX TDM could facilitate the identification of secondary non-responders and in turn, proper IFX use. |
| format |
article |
| author |
Kazuto Nakae Sho Masui Atsushi Yonezawa Motomu Hashimoto Ryu Watanabe Koichi Murata Kosaku Murakami Masao Tanaka Hiromu Ito Kotoko Yokoyama Noriko Iwamoto Takashi Shimada Miyuki Nakamura Masaya Denda Kotaro Itohara Shunsaku Nakagawa Yasuaki Ikemi Satoshi Imai Takayuki Nakagawa Makoto Hayakari Kazuo Matsubara |
| author_facet |
Kazuto Nakae Sho Masui Atsushi Yonezawa Motomu Hashimoto Ryu Watanabe Koichi Murata Kosaku Murakami Masao Tanaka Hiromu Ito Kotoko Yokoyama Noriko Iwamoto Takashi Shimada Miyuki Nakamura Masaya Denda Kotaro Itohara Shunsaku Nakagawa Yasuaki Ikemi Satoshi Imai Takayuki Nakagawa Makoto Hayakari Kazuo Matsubara |
| author_sort |
Kazuto Nakae |
| title |
Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data. |
| title_short |
Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data. |
| title_full |
Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data. |
| title_fullStr |
Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data. |
| title_full_unstemmed |
Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data. |
| title_sort |
potential application of measuring serum infliximab levels in rheumatoid arthritis management: a retrospective study based on kurama cohort data. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/92632b552d964cf2aa8dc1bb174b66c4 |
| work_keys_str_mv |
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