Infliximab therapy intensification upon loss of response: Is there an optimal trough level?

Loss of response (LOR) to infliximab occurs in ∼30% of IBD patients. At time of LOR, lower infliximab-trough-levels (TL), in the absence of anti-drug-antibodies (ATI), have been associated with the need for therapy escalation. Nevertheless, few studies have examined the outcome of infliximab-therapy...

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Bibliographic Details
Published in:Digestive and liver disease 2019-08, Vol.51 (8), p.1106-1111
Main Authors: Ungar, Bella, Ben-Shatach, Zohar, Ben-Haim, Gal, Yavzori, Miri, Picard, Orit, Fudim, Ella, Kopylov, Uri, Veyrard, Pauline, Del Tedesco, Émilie, Paul, Stephane, Eliakim, Rami, Ben-Horin, Shomron, Roblin, Xavier
Format: Article
Language:English
Subjects:
Adult
Antibodies - blood
Biologics
Biomarkers, Pharmacological - blood
Dose-Response Relationship, Drug
Drug Tolerance
Female
France
Humans
IBD
Inflammatory Bowel Diseases - blood
Inflammatory Bowel Diseases - drug therapy
Infliximab
Infliximab - administration & dosage
Infliximab - pharmacokinetics
Israel
Logistic Models
Male
Middle Aged
Multivariate Analysis
Remission Induction
Retrospective Studies
Therapeutic drug monitoring
Therapy
Therapy outcome
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Summary:Loss of response (LOR) to infliximab occurs in ∼30% of IBD patients. At time of LOR, lower infliximab-trough-levels (TL), in the absence of anti-drug-antibodies (ATI), have been associated with the need for therapy escalation. Nevertheless, few studies have examined the outcome of infliximab-therapy intensification, based on different TL. To evaluate the impact of infliximab-TL on efficacy of therapy intensification (dose-elevation/interval-shortening). This was a retrospective observational study performed at two tertiary-centers between 2013–2017. Study population included IBD patients who underwent infliximab therapy escalation (dose elevation/interval shortening) due to clinical LOR. Patients with TL 
ISSN:1590-8658
1878-3562
DOI:10.1016/j.dld.2019.02.013