Development of an Algorithm Incorporating Pharmacokinetics of Adalimumab in Inflammatory Bowel Diseases

Roblin, Xavier; Rinaudo, M.; Tedesco, Émilie Del; Phélip, Jean-Marc; Genin, C; Peyrin–Biroulet, Laurent; Paul, Stéphane

doi:10.1038/ajg.2014.146

Cited by 176 publications

(145 citation statements)

References 12 publications

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“…Roblin et al [18] recently reported a pharmacokinetic analysis of the efficacy of infliximab in IBD patients who showed a loss of response to adalimumab. They demonstrated that switching to infliximab leads to a longterm clinical remission in ATA-positive, adalimumabfailure patients.…”

Section: Discussionmentioning

confidence: 97%

A case of Crohn’s disease that developed anti-infliximab and anti-adalimumab antibodies

Takahashi

Fujimoto

Shioya

et al. 2015

Clin J Gastroenterol

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There are few reports about the rapid appearance of anti-adalimumab antibodies in patients with Crohn's disease positive for anti-infliximab antibodies. We report the case of a 29-year-old female patient with a diagnosis of Crohn's disease who revealed a loss of response to infliximab due to high levels of antibodies to infliximab, and did not respond to the subsequent therapy by adalimumab, with a rapid appearance of antibodies to adalimumab. As one of the possible mechanisms of non-response to adalimumab, immunologic reactivity of infliximab to adalimumab was suspected, since the patient's IgG that was obtained just before the induction of adalimumab reacted with infliximab and adalimumab. We should pay attention to the easy appearance of anti-adalimumab antibodies in association with reactivity of anti-infliximab antibodies to adalimumab in patients with high levels of anti-infliximab antibodies.

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Section: Discussionmentioning

confidence: 97%

A case of Crohn’s disease that developed anti-infliximab and anti-adalimumab antibodies

Takahashi

Fujimoto

Shioya

et al. 2015

Clin J Gastroenterol

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“…11,24 Similar algorithms have been proposed for adalimumab dosing as well. 25 Although the present study was limited by its retrospective nature, relatively small sample size, and limited data for IFX pharmacokinetics, it provides preliminary evidence to suggest that HD IFX may have a role in the treatment of CD. This role probably lies in patients already dose-escalated to 10 mg/kg every 8 weeks, who continue to exhibit a high CRP burden with low serum IFX levels and undetectable ATI.…”

mentioning

confidence: 99%

High-Dose Infliximab Therapy in Crohn’s Disease: Clinical Experience, Safety, and Efficacy

Hendler

Cohen

Colombel

et al. 2015

Journal of Crohn's and Colitis

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Baseline CRP values were significantly elevated in the group that responded at 1-16 weeks compared with nonresponders [22.0 vs 3.5 mg/L, p < 0.01]. HD IFX therapy was discontinued in 26% and 7.3% of patients for inadequate response and adverse events, respectively. Eleven cases of infection required hospitalization for a serious infection rate of 7.41 events per 100 patient-years. Conclusions: HD IFX therapy may benefit CD patients who have failed standard doses of IFX. HD IFX therapy may be associated with more serious adverse events compared with standard dosing. Baseline CRP value may predict clinical response to HD IFX.

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“…Monitoring drug trough concentrations (TCs) and antidrug antibody in guiding treatment strategy has received great interest in recent years [15] . A prospective study that included 82 consecutive IBD patients losing response to adalimumab demonstrated that 67% of patients achieved clinical remission after adalimumab optimization when TCs were <4.9 μg/ml and antibodies against adalimumab (AAA) were negative (<10 ng/ml), compared with 29.2% of patients when TCs were >4.9 μg/ml and 12% when TCs were <4.9 μg/ml and AAA >10 ng/ml (p < 0.01) [16] . Regarding the healthcare cost, treatment optimization based on serum infliximab (IFX) and IFX antibody levels was more cost-effective than IFX dose intensification (34% lower cost) [17] .…”

Section: Top-down Therapymentioning

confidence: 99%

The Future of IBD Therapy: Where Are We and Where Should We Go Next?

Mao

2016

Dig Dis

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Background: The advent of biologic agents opens up a new era for the treatment of inflammatory bowel disease (IBD). In this era, the treatment goal has evolved from the traditional goal of clinical remission to a combination of clinical remission, laboratory normalization and mucosal healing, designated as ‘complete deep remission'. Such complete deep remission comprises a more ambitious disease control strategy that is believed to probably modify the natural course of IBD. Key Messages: To achieve this goal, optimization of current strategy and introduction of novel therapies have gained significant interest. In this concise review, we aim to provide an overview of the current status and future direction of IBD treatment. Specifically, we will describe the application of personalized therapy, development of new biologics, intestinal microbiome manipulation and out-of-the-box agents for IBD. Conclusions: More evidence is still desirable to better optimize the current treatment and apply novel biologics. Personalized medicine has the potential to optimize efficacy, decrease the risk of adverse events and minimize costs and should be proposed as a standard of care for the management of IBD.

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Development of an Algorithm Incorporating Pharmacokinetics of Adalimumab in Inflammatory Bowel Diseases

Cited by 176 publications

References 12 publications

A case of Crohn’s disease that developed anti-infliximab and anti-adalimumab antibodies

A case of Crohn’s disease that developed anti-infliximab and anti-adalimumab antibodies

High-Dose Infliximab Therapy in Crohn’s Disease: Clinical Experience, Safety, and Efficacy

The Future of IBD Therapy: Where Are We and Where Should We Go Next?

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