Clinical Utility of Measuring Infliximab and Human Anti-Chimeric Antibody Concentrations in Patients With Inflammatory Bowel Disease

Afif, Waqqas; Loftus, Edward V.; Faubion, William A.; Kane, Sunanda V.; Bruining, David H.; Hanson, Karen A.; Sandborn, William J.

doi:10.1038/ajg.2010.9

Cited by 441 publications

(402 citation statements)

References 30 publications

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“…Initial reports had suggested that in presence of detectable ATI, dose escalation was generally ineff ective (86% in patients without ATI vs. 17% in patients with detectible ATI, P=0.001 [49]. However, this study utilized a double-antigen assay ELISA unable to simultaneously detect IFX and ATI.…”

Section: Therapeutic Drug Monitoring (Tdm) For Primary Nonresponsementioning

confidence: 83%

Therapeutic Drug Monitoring in Inflammatory Bowel Disease

2017

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Tumor necrosis factor (TNF)-α inhibitors and thiopurines are among the most important classes of medications utilized in the clinical management of Crohn's disease and ulcerative colitis. A signifi cant proportion of patients loses response to these agents or develops adverse eff ects during the course of the treatment. Monitoring of drug levels and anti-drug antibodies (for TNF-α inhibitors) and metabolite levels (for thiopurines) can provide valuable insight into the possible etiology of unfavorable outcomes and allow for an appropriate management strategy for these patients. Th is review summarizes the current knowledge on the clinical implications of therapeutic drug monitoring in infl ammatory bowel disease patients treated with TNF-α inhibitors and thiopurines.

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Section: Therapeutic Drug Monitoring (Tdm) For Primary Nonresponsementioning

confidence: 83%

Therapeutic Drug Monitoring in Inflammatory Bowel Disease

2017

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“…In patients with subtherapeutic infliximab levels (defined by the authors as an undetectable trough concentration or an infliximab concentration<12 mg/ml at 4 weeks after infusion) and negative ATI, dose escalation was associated with a higher clinical response when compared with switching to a different anti-TNFa (86% versus 33% p < 0.016). However, in HACA (ATI) positive patients, switching to another anti-TNFa was associated with a 92% response rate versus 17% with dose escalation (p < 0.004) [Afif et al 2010].…”

Section: Serum Trough Drug Levelsmentioning

confidence: 99%

Exploring the role of monitoring anti-TNFα drug and antibody levels in the management of inflammatory bowel disease

Lim

Panaccione

Seow

2010

Therap Adv Gastroenterol

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Crohn's disease and ulcerative colitis are chronic inflammatory gastrointestinal disorders which often result in significant morbidity or surgery. Current treatment options are not curative and may cause significant adverse effects. The introduction of anti-tumour necrosis factor alpha (anti-TNFa) therapy over a decade ago was a welcome addition to the therapeutic armamentarium and revolutionized the treatment of inflammatory bowel disease (IBD). Despite their relative success, a significant proportion of patients with IBD fail to respond or subsequently lose response anti-TNFa therapy. This review identifies and explores the role of drug levels and immunogenicity (antibody formation) on the efficacy of anti-TNFa therapy and details how monitoring these parameters may help to optimize the management of patients with IBD.

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“…In secondary non-responders, the measurement of trough drug levels and anti-drug antibodies may help guide the subsequent management. In patients with subtherapeutic drug levels, management may involve dose intensification, while patients with detectable antibodies may benefit from switching to another anti-TNF agent [21,22]. Secondary non-responders with adequate trough levels, however, should switch to a different class of agent [21,22].…”

Section: Current Biologics and Unmet Needsmentioning

confidence: 99%

“…In patients with subtherapeutic drug levels, management may involve dose intensification, while patients with detectable antibodies may benefit from switching to another anti-TNF agent [21,22]. Secondary non-responders with adequate trough levels, however, should switch to a different class of agent [21,22]. Second, anti-TNF treatment may increase the risk of infection, as was found with the use of infliximab, for example, which was associated with a 1.4-to 1.6-fold increase in serious infections [23,24].…”

Section: Current Biologics and Unmet Needsmentioning

confidence: 99%

Emerging biologics in inflammatory bowel disease

Chan

2016

J Gastroenterol

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Early biologic therapy is recommended in patients with inflammatory bowel disease and poor prognostic factors and in those refractory to conventional medications. Anti-tumor necrosis factor (anti-TNF) agents are the most commonly used biologic agents. However, some patients may not have an initial response to anti-TNF therapy, and one-third will develop loss of response over time. Anti-TNF drugs can also be associated with side effects. In addition, the use of biologics is currently limited by their cost, especially in developing countries. A number of new therapeutic targets, including novel small molecules, and cellular therapy are available or under investigation. These novel molecules include oral Janus kinase (JAK) inhibitor (tofacitinib), interleukin inhibitor (ustekinumab), oral SMAD7 antisense oligonucleotide (mongersen), and anti-integrin inhibitors (vedolizumab). Here, we review the mechanisms of action, the efficacy, and the safety data of these novel agents. Biological products that are highly similar to reference biologic products whose patents have expired-also known as ''biosimilars''-can be produced at lower cost with similar efficacy, and are also available for the treatment of IBD. We review the efficacy data for such agents as well.

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Clinical Utility of Measuring Infliximab and Human Anti-Chimeric Antibody Concentrations in Patients With Inflammatory Bowel Disease

Cited by 441 publications

References 30 publications

Therapeutic Drug Monitoring in Inflammatory Bowel Disease

Therapeutic Drug Monitoring in Inflammatory Bowel Disease

Exploring the role of monitoring anti-TNFα drug and antibody levels in the management of inflammatory bowel disease

Emerging biologics in inflammatory bowel disease

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