Adequate Infliximab Exposure During Induction Predicts Remission in Paediatric Patients With Inflammatory Bowel Disease

Autor: Gert Van Assche, Ilse Hoffman, Ann Gils, Marc Ferrante, Severine Vermeire, Erwin Dreesen, Karen van Hoeve
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Time Factors
Adolescent
Gastroenterology
Inflammatory bowel disease
Maintenance Chemotherapy
03 medical and health sciences
0302 clinical medicine
Crohn Disease
Gastrointestinal Agents
Predictive Value of Tests
030225 pediatrics
Internal medicine
medicine
Humans
Prospective Studies
Colitis
Child
Infusions
Intravenous
Prospective cohort study
Retrospective Studies
medicine.diagnostic_test
business.industry
Induction chemotherapy
Retrospective cohort study
Induction Chemotherapy
medicine.disease
Infliximab
Logistic Models
Treatment Outcome
Therapeutic drug monitoring
Predictive value of tests
Pediatrics
Perinatology and Child Health
Colitis
Ulcerative
Female
030211 gastroenterology & hepatology
Drug Monitoring
business
Biomarkers
Follow-Up Studies
medicine.drug
Zdroj: Journal of Pediatric Gastroenterology & Nutrition. 68:847-853
ISSN: 1536-4801
0277-2116
Popis: Therapeutic drug monitoring has been proposed as a useful tool in the management of infliximab (IFX) treated patients with inflammatory bowel disease. The aim of this retrospective study was to determine whether IFX trough levels after induction therapy are predictive for outcome at week 52.All pediatric patients with inflammatory bowel disease receiving maintenance IFX at our centre, with IFX trough level available at their first maintenance infusion and a follow-up of at least 52 weeks were included. IFX induction regimens could be intensified at the discretion of the treating physician. All children received proactive drug monitoring during maintenance with dose adaptation aiming to target a therapeutic window of 3 to 7 μg/mL.We included 35 children (23 with Crohn disease and 12 with ulcerative colitis). Median IFX trough levels just before the first maintenance infusion were significantly higher in children achieving clinical (4.6 μg/mL [2.7-11.8] vs 1.5 μg/mL [0.9-3.0]), biological (4.6 μg/mL [2.5-10.3] vs 2.6 μg/mL [0.3-3.2]) and combined clinical/biological remission (6.0 μg/mL [3.2-12.0] vs 2.6 μg/mL [1.1-3.2]) at week 52 compared to children not meeting these criteria (all P ≤ 0.002). Binary logistic regression identified these trough levels as the only predictor for the same outcomes with an odds ratio (95% confidence interval) of 2.083 (1.085-3.998), 2.203 (1.101-4.408), and 2.264 (1.096-4.680), respectively (all P 0.05).Adequate IFX exposure during induction therapy is associated with better clinical and/or biological remission at week 52. Postinduction IFX trough levels were the only predictor for clinical and/or biological remission at week 52.
Databáze: OpenAIRE
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