Year 2020 / Volume 112 / Number 5
Original
Usefulness of therapeutic drug monitoring of infliximab during the induction period in patients with inflammatory bowel disease

360-366

DOI: 10.17235/reed.2020.6618/2019

Mayte Gil Candel, Juan José Gascón Cánovas, Elena Urbieta Sanz, Rosa Gómez Espín, Isabel Nicolás de Prado, Carles Iniesta Navalón,

Abstract
Introduction: previous studies have shown that higher infliximab trough levels are associated with favorable short-term and long-term therapeutic outcomes in inflammatory bowel disease. There is a need to determine which patients could benefit from proactive therapeutic drug monitoring in the induction phase. The aim of this study was to evaluate the pharmacokinetic variability of infliximab, determine the factors associated with achieving target infliximab trough levels in the induction phase and analyze the clinical and biochemical response at week 26 of treatment. Patients and methods: a retrospective observational study was performed of patients with inflammatory bowel disease and data available on serum levels of infliximab during the induction period. The percentage of patients that achieved target infliximab trough levels at week 6 was determined. Clinical remission and response and biochemical remission were evaluated at week 26. Results: thirty patients were included and only 13 (43.3 %) had infliximab trough levels > 15 µg/mL at week 6. A clinical response was observed during the maintenance period in 71.4 % of patients, their infliximab levels were significantly higher than in non-responders (6.3 µg/mL [IQR: 6.7] vs 1.0 µg/mL [IQR: 5.0], respectively; p = 0.016). Likewise, 53.6 % of patients achieved biochemical remission (responders 6.2 µg/mL [IQR: 5.2] vs non-responders 3.2 µg/mL [IQR: 5.0]; p = 0.031). Conclusion: less than half of patients had target infliximab levels during the induction period. Therapeutic drug monitoring during this period is related to the achievement of therapeutic levels of infliximab and may lead to a better clinical response in these patients.
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10/06/2020 20:26:32
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Gil Candel M, Gascón Cánovas J, Urbieta Sanz E, Gómez Espín R, Nicolás de Prado I, Iniesta Navalón C, et all. Usefulness of therapeutic drug monitoring of infliximab during the induction period in patients with inflammatory bowel disease. 6618/2019


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Publication history

Received: 08/09/2019

Accepted: 11/11/2019

Online First: 27/04/2020

Published: 08/05/2020

Article revision time: 62 days

Article Online First time: 232 days

Article editing time: 243 days


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