Estudio piloto sobre la utilidad de la monitorización de niveles y anticuerpos anti-infliximab en pacientes con enfermedad inflamatoria intestinal en práctica clínica. estudio “inflixilevel”.

Introduction and aims of this study: the measurement of serum levels and antibodies of biologics is a new tool to optimize therapy in patients with inflammatory bowel disease. According to clinical practice, we analyzed the usefulness of measuring infliximab levels and antibodies in our center. Mate...

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Detalles Bibliográficos
Autores: Valdés-Delgado, T, Argüelles Arias, Federico, Guerra-Veloz, M.F, Merino, V, Maldonado-Pérez, M, Castro Laria, L, Caunedo-Álvarez, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/172019
Acceso en línea:https://hdl.handle.net/11441/172019
Access Level:acceso abierto
Palabra clave:Niveles De Infliximab
Anticuerpos De Infliximab
Monitorización De Niveles
Infliximab
Infliximab Levels
Infliximab Antibodies
Level Monitoring
Descripción
Sumario:Introduction and aims of this study: the measurement of serum levels and antibodies of biologics is a new tool to optimize therapy in patients with inflammatory bowel disease. According to clinical practice, we analyzed the usefulness of measuring infliximab levels and antibodies in our center. Material and methods: observational and prospective study of patients with Inflammatory Bowel Disease undergoing treatment with infliximab between july 2016 and july 2017. Between 2-3 measurements of the valley levels of the drug and its serum antibodies were carried out and the therapy was adjusted according to the algorithm proposed in the TAXIT study (accepted therapeutic range 3-7 mcg/ml) and the patient's history. Results: the study included 157 patients. In 75.7% of cases it was posible to determine both the serum levels and antibodies. In 22.3% (35/157) of cases, the levels were in the therapeutic range. In all these cases, it was decided to continue the treatment. In 35.7% (56/157) of patients, the levels were above the therapeutic range. Treatment was deintensified in 11 patients because they were clinically well and changed in 10 patients. In 42% (66/157) of cases the levels were in the infra-therapeutic range. In 18 cases treatment was intensified because there was no clinical remission. In 7 patients, treatment was stopped because of antibody development and changed to another drug, and in 4 cases treatment was withdrawn because of sustained clinical remission. Conclusions: the determination of infliximab levels adds to the usual clinical practice an objective parameter to individualize the adjustment of the therapeutic treatments although it is necessary to follow the evolution of our cohort of patients to know if it is really effective.