Infliximab serum concentrations in luminal Crohn's disease and its relationship with disease activity: A multicentric
Rodrigo Bremer Nones1, Eron Fabio Miranda2, Gustavo de Nardi Marçal2
1IBD Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil.
Insights
Serum Infliximab (IFX) concentrations were similar in Crohn's disease patients with general, endoscopic, or lab-confirmed active disease versus remission. However, clinically active disease showed lower IFX levels.
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Monitoring serum Infliximab (IFX) concentrations is crucial for optimizing treatment in Crohn's disease (CD).
- Limited data exists on IFX concentration monitoring in Latin America.
- Understanding IFX levels in relation to disease activity is essential for patient management.
Purpose of the Study:
- To compare serum Infliximab (IFX) concentrations between patients with active luminal Crohn's disease (CD) and those in remission.
- To assess the relationship between IFX trough levels and different markers of disease activity.
Main Methods:
- A cross-sectional study involving 80 patients with luminal CD on maintenance IFX therapy.
- Patients were categorized into remission or active disease groups based on clinical, endoscopic, radiological, and laboratory assessments.
- Serum IFX trough levels were measured and compared between the groups.
Main Results:
- No significant difference in median serum IFX levels was observed between patients in remission (5.63) and those with general active disease (3.84).
- IFX concentrations did not differ significantly across endoscopic, radiological, or laboratory markers of disease activity.
- A significant difference was found in clinical evaluation, with lower median IFX levels in patients with clinically active disease (2.14) compared to those in remission (5.63).
Conclusions:
- Serum IFX concentrations during maintenance therapy are comparable in patients with luminal CD experiencing remission or general, endoscopic, radiological, and laboratory disease activity.
- Clinically active disease is associated with lower serum Infliximab concentrations, suggesting potential for dose adjustment in this subgroup.
Objectives:
In Latin America, experience with monitoring serum Infliximab (IFX) concentrations is scarce. Our study aimed to compare IFX serum concentrations between patients with active disease or in remission.
Patients And Methods:
A cross-sectional study was performed in patients with luminal Crohn's disease (CD) during maintenance treatment with IFX. Patients were classified as in remission or disease activity according to clinical scores and endoscopic, radiological, and laboratory markers. A comparison of IFX trough levels between the two groups was performed.
Results:
80 CD patients were included [41 (51%) in remission and 39 (49%) with active disease]. In the analysis of general disease activity, the median serum levels of IFX in patients with remission and with active CD were 5.63 [0.03-14.40] vs. 3.84 [0.03-14.40] (p=0.287). Furthermore, there was no difference in serum IFX concentrations in endoscopic, radiological, and laboratory activities. Only in the clinical evaluation there was a significant difference in the median serum IFX levels between patients in remission and disease activity, 5.63 [0.03-14.40] vs. 2.14 [0.32-10.54] (p=0.042).
Conclusions:
IFX serum concentrations during maintenance treatment were similar in patients with luminal CD in remission and general, endoscopic, radiological, and laboratory disease activity. Patients with clinically active disease had lower IFX concentrations than patients in remission.
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