Therapeutic Drug Monitoring of Infliximab and Mucosal Healing in Inflammatory Bowel Disease

• DOI: 10.1097/mib.0b013e3182a77b41
• Publication Date: 2013-09-07T01:17:17Z
• Authors: Stephane Paul; Emilie Del Tedesco; Hubert Marotte; Melanie Rinaudo-G...; Amelie Moreau; Jean-Marc Phelip; Christian Genin; Laurent Peyrin-Bi...; Xavier Roblin
• Keywords: Therapeutic Drug Monitoring; Faecal calprotectin; Trough level

Data on the value of therapeutic drug monitoring infliximab (IFX) to predict mucosal healing (MH) in inflammatory bowel diseases (IBD) are scarce.All consecutive patients with IBD receiving ongoing IFX (5 mg/kg) treatment and developing secondary failure were enrolled a prospective study between June 2010 May 2011. trough levels, antibodies concentrations, C-reactive protein fecal calprotectin measured before optimization at week 8. A proctosigmoidoscopy was performed day first 8 all ulcerative colitis (UC). MH defined by <250 μg/g stools Crohn's disease (CD) an endoscopic Mayo score 0 or 1 UC.This included 52 IBD: 34 CD (mean Disease Activity Index, 300; mean protein, 28 ± 10 mg/L; calprotectin, 705 300 μg/g) 18 UC Simple Clinical Colitis 7; score, 3). After dose intensification, half achieved MH. Increase levels (called "delta IFX" micrograms per milliliter) associated both (P = 0.001). delta >0.5 μg/mL (sensitivity [se], 0.88; specificity [sp], 0.77; P 0.0001, area under receiver operating characteristic curve, 0.89). On multivariate analysis, only factor after µg/mL (likelihood ratio 2.02; 95% confidence interval, 1.01-4.08; 0.048) IBD.Therapeutic strongly predicts likelihood achieving following intensification UC.