Infliximab Concentration Thresholds During Induction Therapy Are Associated With Short-term Mucosal Healing in Patients With Ulcerative Colitis
| Autor: | Sophie Tops, Marc Ferrante, Paul Rutgeerts, Thomas Billiet, Niels Vande Casteele, Konstantinos Papamichael, Ann Gils, Gert Van Assche, Severine Vermeire, Karolien Claes, Thomas Van Stappen |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Hepatology business.industry Gastroenterology Area under the curve Odds ratio medicine.disease Inflammatory bowel disease Ulcerative colitis Infliximab Confidence interval Surgery 03 medical and health sciences 0302 clinical medicine Intestinal mucosa Interquartile range 030220 oncology & carcinogenesis Internal medicine medicine 030211 gastroenterology & hepatology business medicine.drug |
| Zdroj: | Clinical Gastroenterology and Hepatology. 14:543-549 |
| ISSN: | 1542-3565 |
| DOI: | 10.1016/j.cgh.2015.11.014 |
| Popis: | Background & Aims Mucosal healing is an independent predictor of sustained clinical remission in patients with ulcerative colitis (UC) treated with infliximab. We investigated whether infliximab concentrations during induction therapy are associated with short-term mucosal healing (STMH) in patients with UC. Methods We performed a retrospective, single-center analysis of data collected from a tertiary referral center from 101 patients with UC who received scheduled induction therapy with infliximab at weeks 0, 2, and 6 and had an endoscopic evaluation at baseline and after induction therapy. STMH was defined as Mayo endoscopic sub-score ≤1, assessed at weeks 10–14, with baseline sub-score ≥2. Infliximab concentrations were evaluated in serum samples collected at weeks 0, 2, 6, and 14 of infliximab therapy by using an enzyme-linked immunosorbent assay we developed. Results Fifty-four patients (53.4%) achieved STMH. Patients with STMH had a higher median infliximab concentration at weeks 2, 6, and 14 than patients without STMH. A receiver operating characteristic (ROC) analysis identified infliximab concentration thresholds of 28.3 (area under the ROC curve [AUROC], 0.638), 15 (AUROC, 0.688), and 2.1 μg/mL (AUROC, 0.781) that associated with STMH at weeks 2, 6, and 14, respectively. Multiple logistic regression analysis identified infliximab concentration ≥15 at week 6 ( P = .025; odds ratio, 4.6; 95% confidence interval, 1.2–17.1) and ≥2.1 μg/mL at week 14 ( P = .004; odds ratio, 5.6; 95% confidence interval, 1.7–18) as independent factors associated with STMH. Conclusions In an analysis of data from real-life clinical practice, we associated infliximab concentrations during the induction therapy with STMH in patients with UC. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|