Clinical role, optimal timing and frequency of serum infliximab and anti-infliximab antibody level measurements in patients with inflammatory bowel disease

BACKGROUND: Serum infliximab (IFX) and antibody-to-infliximab (ATI) levels are objective parameters, that may have a great role in the therapeutic decisions during maintenance biological therapy. RESEARCH DESIGN AND METHODS: 48 inflammatory bowel disease patients receiving maintenance IFX therapy we...

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Bibliographic Details
Main Authors: Bor Renáta
Farkas Klaudia
Fábián Anna
Bálint Anita
Milassin Ágnes
Rutka Mariann
Matuz Mária
Nagy Ferenc
Szepes Zoltán
Molnár Tamás
Format: Article
Published: Public Library of Science (PLoS) 2017
Series:PLOS ONE 12 No. 3
Subjects:
doi:10.1371/journal.pone.0172916

mtmt:3220191
Online Access:http://publicatio.bibl.u-szeged.hu/11479
Description
Summary:BACKGROUND: Serum infliximab (IFX) and antibody-to-infliximab (ATI) levels are objective parameters, that may have a great role in the therapeutic decisions during maintenance biological therapy. RESEARCH DESIGN AND METHODS: 48 inflammatory bowel disease patients receiving maintenance IFX therapy were prospectively enrolled and divided into adequate (complete remission N = 20) and inadequate responder (partial response, loss of response, dose escalation; N = 28) groups. Blood samples were collected just before (trough level, TL) and two (W2aTL) and six weeks (W6aTL) after the administration of IFX. RESULTS: Single measurement of ATI titer was insufficient for predicting therapeutic response due to transient expression of ATI, however, using the three points' measurements, significant difference has been detected between the adequate and inadequate responder group (5.0% vs 35.7%; p = 0.016). The mean value of TL was significantly higher in the adequate responder group (3.11+/-1.64 vs.1.19+/-1.11; p<0.001) without further difference on the second and sixth week. Sensitivity and specificity for predicting the therapeutic response were 85.0% and 71.4% based on the cut-off value of TL 2.0 mug/ml. CONCLUSION: Simultaneous measurement of serum IFX level prior to administration of regular IFX infusion and ATI titers significantly increase the diagnostic accuracy for the therapeutic decision in patients uncertainly responding to the therapy. The measurement of W2aTL and W6aTL levels did not result in further improvement in the prediction of therapeutic response.
Physical Description:e0172916
ISSN:1932-6203