Proactive Infliximab Monitoring Improves the Rates of Transmural Remission in Crohn's Disease: A Propensity...

Area of Science:

• Gastroenterology
• Immunology
• Pharmacology

Background:

• Crohn's disease (CD) treatment often fails to achieve transmural remission.
• Current therapies have limitations in improving outcomes for CD patients.
• Optimizing infliximab (IFX) therapy may enhance remission rates.

Purpose of the Study:

• To evaluate the impact of proactive therapeutic drug monitoring of infliximab (IFX) on transmural remission rates in Crohn's disease (CD).
• To compare transmural remission rates between CD patients receiving proactive IFX monitoring versus those without.

Main Methods:

• Retrospective cohort study of 195 consecutive CD patients initiating IFX therapy.
• Comparison of transmural remission rates in patients with and without proactive therapeutic drug monitoring (target: 5-7 µg/mL).
• Propensity score-matched analysis and multivariate analysis to adjust for confounders.

Main Results:

• Higher transmural remission rates were observed in patients with proactive IFX monitoring (37.2% vs 18.3%; P=.004).
• Propensity score-matched analysis confirmed improved remission rates (34.2% vs 17.1%; P=.025).
• Proactive monitoring was independently associated with achieving transmural remission (OR, 2.95; P=.003).

Conclusions:

• Proactive optimization of infliximab (IFX) trough levels is effective in increasing transmural remission rates for Crohn's disease (CD) patients.
• Therapeutic drug monitoring of IFX represents a valuable strategy for improving treatment outcomes in CD.