THE EVALUATION OF INFLIXIMAB TROUGH LEVEL FAVORS MAINTENANCE THERAPY OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Area of Science:

• Gastroenterology
• Immunology
• Pharmacology

Background:

• Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), involves immune system deregulation in the gut.
• Biological therapies like infliximab (IFX) are key treatments for IBD.
• Monitoring IFX treatment involves fecal calprotectin (FC), C-reactive protein (CRP), imaging, and serum IFX and antibody levels.

Purpose of the Study:

• To evaluate trough levels (TL) and antibodies in IBD patients treated with IFX.
• To identify factors influencing IFX treatment effectiveness.

Main Methods:

• Retrospective, cross-sectional study conducted in a southern Brazilian hospital from June 2014 to July 2016.
• Assessed serum IFX trough levels and anti-drug antibody (ATI) levels in IBD patients.
• Analyzed 95 blood samples from 55 patients diagnosed with CD or UC.

Main Results:

• Serum IFX levels were adequate in 31.57%, subtherapeutic in 43.15%, and supratherapeutic in 25.26% of samples.
• IFX dosages were optimized for 42.10% of patients, maintained for 32.63%, and discontinued for 7.60%.
• Therapeutic decisions were based on IFX and/or antibody levels in 55.79% of tests; nearly 70% of patients maintained IFX therapy after one year.

Conclusions:

• No significant differences in TL were observed based on immunosuppressant use, albumin, ESR, FC, CRP, or imaging results.
• Serum IFX and antibody level monitoring is a valuable tool for managing IBD patients on maintenance therapy and post-induction.
• The current therapeutic approach, guided by serum levels, allowed for the maintenance of IFX treatment in a majority of patients.