Utilidad de la monitorización terapéutica de infliximab en el manejo de la enfermedad inflamatoria intestinal

Background: Primary non-response and secondary loss of response (LOR) are significant problems of biological therapy for inflammatory bowel disease (IBD). Therapeutic drug monitoring (TDM) in IBD patients receiving these drugs can improve outcomes. Aim: To measure serum infliximab levels and anti-...

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Autores principales:	Quera,Rodrigo, Moreno,Mauricio, Simian,Daniela, Ibáñez,Patricio, Lubascher,Jaime, Figueroa,Carolina, Flores,Lilian, Kronberg,Udo, Pizarro,Gonzalo, Fluxá,Daniela
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2018
Materias:	Crohn Disease Ulcerative colitis Drug Monitoring Infliximab Therapeutics
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018001101241
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spelling	oai:scielo:S0034-988720180011012412019-02-13Utilidad de la monitorización terapéutica de infliximab en el manejo de la enfermedad inflamatoria intestinalQuera,RodrigoMoreno,MauricioSimian,DanielaIbáñez,PatricioLubascher,JaimeFigueroa,CarolinaFlores,LilianKronberg,UdoPizarro,GonzaloFluxá,Daniela Crohn Disease Ulcerative colitis Drug Monitoring Infliximab Therapeutics Background: Primary non-response and secondary loss of response (LOR) are significant problems of biological therapy for inflammatory bowel disease (IBD). Therapeutic drug monitoring (TDM) in IBD patients receiving these drugs can improve outcomes. Aim: To measure serum infliximab levels and anti-infliximab antibodies (ATI) in patients with IBD post-induction phase and during maintenance therapy assessing the clinical course of IBD. Patients and Methods: Prospective study of IBD patients receiving infliximab between July 2016-May 2017. Group-A included patients who received induction therapy while Group-B included patients who were in maintenance therapy. TDM was performed in serum samples collected at weeks-14 and 30 in Group-A and before the infliximab maintenance dose in Group-B. Clinical scores, fecal calprotectin and endoscopic score were also evaluated. Results: Of 14 patients in Group-A, 57% achieved endoscopic response. Median serum infliximab concentrations at week-14 and 30 were 2.65 AU/mL (0.23-32.58) and 2.3 AU/mL (0.3-16.8), respectively. Patients with mucosal healing had non-significantly higher median infliximab concentrations at week- 14, as compared to week 30 (median 3.2 vs 2.2 AU/ml, respectively, p 0.6). ATI >10 ug/mL were found in one and seven patients at week-14 and 30, respectively. At 52 weeks of follow-up, four patients (31%) had LOR. Group-B included 36 patients, 33% had LOR. Median serum concentrations of infliximab were 1.4 AU/mL (0.27-7.03). No significant differences in serum infliximab concentration were observed between patients in remission and those with inflammatory activity. Seventeen patients had ATI >10 ug/mL. Conclusions: Clinical algorithms using TDM might help to optimize the pharmacological therapy of IBD.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.146 n.11 20182018-11-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018001101241es10.4067/S0034-98872018001101241
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Crohn Disease Ulcerative colitis Drug Monitoring Infliximab Therapeutics
spellingShingle	Crohn Disease Ulcerative colitis Drug Monitoring Infliximab Therapeutics Quera,Rodrigo Moreno,Mauricio Simian,Daniela Ibáñez,Patricio Lubascher,Jaime Figueroa,Carolina Flores,Lilian Kronberg,Udo Pizarro,Gonzalo Fluxá,Daniela Utilidad de la monitorización terapéutica de infliximab en el manejo de la enfermedad inflamatoria intestinal
description	Background: Primary non-response and secondary loss of response (LOR) are significant problems of biological therapy for inflammatory bowel disease (IBD). Therapeutic drug monitoring (TDM) in IBD patients receiving these drugs can improve outcomes. Aim: To measure serum infliximab levels and anti-infliximab antibodies (ATI) in patients with IBD post-induction phase and during maintenance therapy assessing the clinical course of IBD. Patients and Methods: Prospective study of IBD patients receiving infliximab between July 2016-May 2017. Group-A included patients who received induction therapy while Group-B included patients who were in maintenance therapy. TDM was performed in serum samples collected at weeks-14 and 30 in Group-A and before the infliximab maintenance dose in Group-B. Clinical scores, fecal calprotectin and endoscopic score were also evaluated. Results: Of 14 patients in Group-A, 57% achieved endoscopic response. Median serum infliximab concentrations at week-14 and 30 were 2.65 AU/mL (0.23-32.58) and 2.3 AU/mL (0.3-16.8), respectively. Patients with mucosal healing had non-significantly higher median infliximab concentrations at week- 14, as compared to week 30 (median 3.2 vs 2.2 AU/ml, respectively, p 0.6). ATI >10 ug/mL were found in one and seven patients at week-14 and 30, respectively. At 52 weeks of follow-up, four patients (31%) had LOR. Group-B included 36 patients, 33% had LOR. Median serum concentrations of infliximab were 1.4 AU/mL (0.27-7.03). No significant differences in serum infliximab concentration were observed between patients in remission and those with inflammatory activity. Seventeen patients had ATI >10 ug/mL. Conclusions: Clinical algorithms using TDM might help to optimize the pharmacological therapy of IBD.
author	Quera,Rodrigo Moreno,Mauricio Simian,Daniela Ibáñez,Patricio Lubascher,Jaime Figueroa,Carolina Flores,Lilian Kronberg,Udo Pizarro,Gonzalo Fluxá,Daniela
author_facet	Quera,Rodrigo Moreno,Mauricio Simian,Daniela Ibáñez,Patricio Lubascher,Jaime Figueroa,Carolina Flores,Lilian Kronberg,Udo Pizarro,Gonzalo Fluxá,Daniela
author_sort	Quera,Rodrigo
title	Utilidad de la monitorización terapéutica de infliximab en el manejo de la enfermedad inflamatoria intestinal
title_short	Utilidad de la monitorización terapéutica de infliximab en el manejo de la enfermedad inflamatoria intestinal
title_full	Utilidad de la monitorización terapéutica de infliximab en el manejo de la enfermedad inflamatoria intestinal
title_fullStr	Utilidad de la monitorización terapéutica de infliximab en el manejo de la enfermedad inflamatoria intestinal
title_full_unstemmed	Utilidad de la monitorización terapéutica de infliximab en el manejo de la enfermedad inflamatoria intestinal
title_sort	utilidad de la monitorización terapéutica de infliximab en el manejo de la enfermedad inflamatoria intestinal
publisher	Sociedad Médica de Santiago
publishDate	2018
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018001101241
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Utilidad de la monitorización terapéutica de infliximab en el manejo de la enfermedad inflamatoria intestinal

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