Efficacy of Early Optimization of Infliximab Guided by Therapeutic Drug Monitoring during Induction-A Prospective Trial

Imagem de Miniatura
Arquivos
art_GARCIA_Efficacy_of_Early_Optimization_of_Infliximab_Guided_by_2023.PDF (1.97 MB)
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
MDPI
Autores
PARRA, Rogerio Serafim
Citação
BIOMEDICINES, v.11, n.6, article ID 1757, 15p, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Therapeutic drug monitoring (TDM) during induction therapy with anti-tumor necrosis factor drugs has emerged as a strategy to optimize response to these biologics and avoid undesired outcomes related to inadequate drug exposure. This study aimed to describe clinical, biological, and endoscopic remission rates at six months in Brazilian inflammatory bowel disease (IBD) patients following a proactive TDM algorithm guided by IFX trough levels (ITL) and antibodies to IFX (ATI) levels during induction, at week six. A total of 111 IBD patients were prospectively enrolled, excluding those previously exposed to the drug. ITL & GE; 10 & mu;g/mL was considered optimal. Patients with suboptimal ITL (<10 & mu;g/mL) were guided according to ATI levels. Those who presented ATI & LE; 200 ng/mL underwent dose intensification in the maintenance phase, and patients with ATI > 200 ng/mL discontinued IFX. In our study, proactive TDM was associated with persistence in the IFX rate at six months of 82.9%. At that time, rates of clinical, biological, and endoscopic remission in patients under IFX treatment were 80.2%, 73.9%, and 48.1%, respectively. Applying a simplified TDM-guided algorithm during induction seems feasible and can help improve patients' outcomes in clinical practice.
Palavras-chave
inflammatory bowel diseases, tumor necrosis factor-alpha, infliximab, therapeutic drug monitoring, Crohn's disease, ulcerative colitis
URI
https://observatorio.fm.usp.br/handle/OPI/54941
Referências
  1. Adedokun OJ, 2014, GASTROENTEROLOGY, V147, P1296, DOI 10.1053/j.gastro.2014.08.035
  2. Allez M, 2010, J CROHNS COLITIS, V4, P355, DOI 10.1016/j.crohns.2010.04.004
  3. Bar-Yoseph H, 2018, ALIMENT PHARM THER, V47, P212, DOI 10.1111/apt.14410
  4. Ben-Horin S, 2011, ALIMENT PHARM THER, V33, P987, DOI 10.1111/j.1365-2036.2011.04612.x
  5. Bossuyt P, 2022, J CROHNS COLITIS, V16, P199, DOI 10.1093/ecco-jcc/jjab127
  6. Brandse JF, 2015, GASTROENTEROLOGY, V149, P350, DOI 10.1053/j.gastro.2015.04.016
  7. Cheifetz AS, 2021, AM J GASTROENTEROL, V116, P2014, DOI 10.14309/ajg.0000000000001396
  8. Colombel JF, 2019, CLIN GASTROENTEROL H, V17, P1525, DOI 10.1016/j.cgh.2018.09.033
  9. Davidov Y, 2017, J CROHNS COLITIS, V11, P549, DOI 10.1093/ecco-jcc/jjw182
  10. Dreesen E, 2018, J CROHNS COLITIS, V12, pS63
  11. Feuerstein JD, 2017, GASTROENTEROLOGY, V153, P827, DOI 10.1053/j.gastro.2017.07.032
  12. Sanchez-Hernandez JG, 2020, BRIT J CLIN PHARMACO, V86, P1165, DOI 10.1111/bcp.14229
  13. Hanauer SB, 2002, LANCET, V359, P1541, DOI 10.1016/S0140-6736(02)08512-4
  14. Hemperly A, 2018, CLIN PHARMACOKINET, V57, P929, DOI 10.1007/s40262-017-0627-0
  15. Kennedy NA, 2019, LANCET GASTROENTEROL, V4, P341, DOI 10.1016/S2468-1253(19)30012-3
  16. Lega S, 2019, INFLAMM BOWEL DIS, V25, P134, DOI 10.1093/ibd/izy203
  17. Melmed GY, 2016, CLIN GASTROENTEROL H, V14, P1302, DOI 10.1016/j.cgh.2016.05.010
  18. Papamichael K, 2018, ALIMENT PHARM THER, V47, P478, DOI 10.1111/apt.14458
  19. Papamichael K, 2022, BMJ OPEN, V12, DOI 10.1136/bmjopen-2021-057656
  20. Papamichael K, 2022, LANCET GASTROENTEROL, V7, P171, DOI 10.1016/S2468-1253(21)00223-5
  21. Papamichael K, 2019, CLIN GASTROENTEROL H, V17, P1655, DOI 10.1016/j.cgh.2019.03.037
  22. Papamichael K, 2017, INFLAMM BOWEL DIS, V23, P1510, DOI 10.1097/MIB.0000000000001231
  23. Papamichael K, 2016, CLIN GASTROENTEROL H, V14, P543, DOI 10.1016/j.cgh.2015.11.014
  24. Papamichael K, 2015, INFLAMM BOWEL DIS, V21, P182, DOI 10.1097/MIB.0000000000000202
  25. Rutgeerts P, 2005, NEW ENGL J MED, V353, P2462, DOI 10.1056/NEJMoa050516
  26. Singh S, 2018, ALIMENT PHARM THER, V47, P162, DOI 10.1111/apt.14422
  27. Sparrow MP, 2020, J CROHNS COLITIS, V14, P543, DOI 10.1093/ecco-jcc/jjz162
  28. Syversen SW, 2021, JAMA-J AM MED ASSOC, V325, P1744, DOI 10.1001/jama.2021.4172
  29. Turner D, 2021, GASTROENTEROLOGY, V160, P1570, DOI 10.1053/j.gastro.2020.12.031
  30. Vande Casteele N, 2019, CLIN GASTROENTEROL H, V17, P1814, DOI 10.1016/j.cgh.2018.10.036
  31. Vande Casteele N, 2015, GASTROENTEROLOGY, V148, P1320, DOI 10.1053/j.gastro.2015.02.031
  32. Vaughn BP, 2014, INFLAMM BOWEL DIS, V20, P1996, DOI 10.1097/MIB.0000000000000156
  33. Vermeire S, 2020, CLIN GASTROENTEROL H, V18, P1291, DOI 10.1016/j.cgh.2019.09.041

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - LIM/07