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    Infliximab: a single-centre, prospective, observational evaluation of TDM data in patients with IBD

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    Author
    Gadsby, Jessica
    Hall, Karen
    Shah, Fatima
    Pattni, Sanjeev
    Gethins, Sharon
    Mulla, Hussain
    Keyword
    Drug monitoring
    Gastroenterology
    Inflammatory bowel disease
    
    Metadata
    Show full item record
    DOI
    https://doi.org/10.1136/ejhpharm-2021-003015
    Publisher's URL
    https://ejhp.bmj.com/content/early/2022/02/24/ejhpharm-2021-003015.long
    Abstract
    Objectives: Therapeutic drug monitoring of infliximab (IFX) is important to optimise treatment of inflammatory bowel disease (IBD). A recent IBD consensus statement recommends targeting trough serum concentrations of >3 μg/mL, higher than our local recommendation of >1 μg/mL. We therefore investigated the relationship between IFX trough concentrations and C reactive protein (CRP), faecal calprotectin (FCP), clinical outcomes and anti-IFX antibody (AB) development as well as the influence of concomitant thiopurine treatment. Methods: Observational data, prospectively collected in a cohort of adult patients with IBD newly initiated on IFX at a single centre. Results: IFX concentrations >3 μg/mL were associated with a greater reduction in CRP (% change from baseline) and lower FCP; mean (SD) 47 (33.8) % vs 102.3 (136.9) % and 233.9 (505.1) μg/g vs 416.3 (613.5) μg/g, respectively. Lower IFX concentrations were observed in patients who developed AB than those who did not, mean (range) 6.2 (1.1-10) μg/mL vs 0.9 (0.4-4.9) μg/mL, respectively, and also in patients who stopped/switched therapy compared with those who continued, 2.4 (2.9) μg/mL vs 6.5 (2.8) μg/mL; p=0.0002. Patients taking a concomitant thiopurine were found to have higher IFX concentrations; mean (range) 6.4 (0.7-10) μg/mL vs 3.9 (0.4-10) μg/mL. Conclusions: IFX concentrations are correlated with biomarkers, clinical response and AB development in patients with IBD. Concomitant thiopurine therapy appears to be associated with higher IFX concentrations and reduced likelihood of AB development.
    Citation
    Gadsby, J., Hall, K., Shah, F., Pattni, S., Gethins, S., & Mulla, H. (2022). Infliximab: a single-centre, prospective, observational evaluation of TDM data in patients with IBD. European journal of hospital pharmacy : science and practice, ejhpharm-2021-003015. Advance online publication.
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15366
    Collections
    Pharmacy
    Gastroenterology

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