Infliximab Exposure Associates With Radiologic Evidence of Healing in Patients With Crohn’s Disease

Bossuyt, Peter; Dreesen, Erwin; Rimola, Jordi; Devuysere, S; Bruecker, Yves De; Vanslembrouck, Ragna; Laurent, V.; Zappa, Magaly; Savoye‐Collet, Céline; Pariente, Benjamin; Filippi, Jérôme; Baert, Filip; D’Haens, Geert R.; Laharie, David; Peyrin–Biroulet, Laurent; Vermeire, Séverine; Lambrecht, Guy; Buisson, Anthony; Bouhnik, Yoram; Woude, Janneke V.; Hootegem, Philippe Van; Moreau, Jacques; Louis, Édouard; Franchimont, Denis; Vos, Martine De; Mana, Fazia; Brixi, Hédia; Allez, Matthieu; Caenepeel, Philip; Aubourg, Alexandre; Oldenburg, Bas; Pierik, Marieke; Chevret, Sylvie

doi:10.1016/j.cgh.2020.04.052

Cited by 20 publications

(9 citation statements)

References 28 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One limitation of the study is the lower cut-off used for infliximab trough concentrations compared to the recommended trough concentration on a technical review from the American Gastroenterological Association and used in the TAILORIX trial MRE substudy. 9,10 In summary, this study demonstrates that short-term radiological…”

supporting

confidence: 52%

“…It also remains unclear whether ileal location on anti‐TNF response signifies a need for dose escalation, especially when there are high segmental MaRIA scores. One limitation of the study is the lower cut‐off used for infliximab trough concentrations compared to the recommended trough concentration on a technical review from the American Gastroenterological Association and used in the TAILORIX trial MRE substudy 9,10 …”

mentioning

confidence: 99%

See 1 more Smart Citation

Editorial: crystal gazing with magnetic resonance enterography to predict the response to TNF‐alpha inhibitors in Crohn's disease

Zulfiqar

Deepak

2020

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

supporting

confidence: 52%

mentioning

confidence: 99%

Editorial: crystal gazing with magnetic resonance enterography to predict the response to TNF‐alpha inhibitors in Crohn's disease

Zulfiqar

Deepak

2020

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…In a post hoc analysis of the TAILORIX study by Dreesen et al, 53 infliximab trough levels after dose escalation were found to be significantly higher in patients without endoscopic ulceration at 54 weeks compared to those with endoscopic ulceration (8.0 μg/mL [6.7‐9.3] vs 5.1 μg/mL [4.5‐5.8], P = 0.002). Similarly, an infliximab trough level >7 μg/mL at all time points following dose escalation was associated with radiologic response ( P = 0.039) and remission ( P = 0.019) in a sub‐group analysis of the TAILORIX cohort 75 . In five studies, however, an exposure‐response relationship following treatment intensification was not observed 23,68,72‐74,76 …”

Section: Resultsmentioning

confidence: 97%

“…Similarly, an infliximab trough level >7 μg/mL at all time points following dose escalation was associated with radiologic response (P = 0.039) and remission (P = 0.019) in a sub-group analysis of the TAILORIX cohort. 75 In five studies, however, an exposure-response relationship following treatment intensification was not observed. 23,68,[72][73][74]76…”

Section: Relationship Between Anti-tnf Dosing Schedule and Serum Drug Levelmentioning

confidence: 96%

Systematic review: efficacy of escalated maintenance anti‐tumour necrosis factor therapy in Crohn's disease

Mattoo

Basnayake

Connell

et al. 2021

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Summary Background Loss of response to anti‐TNF agents is a common clinical problem. Dose escalation may be effective for reestablishing clinical response in Crohn's disease (CD). Aims To perform a systematic review assessing the efficacy of escalated maintenance anti‐TNF therapy in CD. Methods EMBASE, MEDLINE, Web of Science, and CENTRAL databases were searched for English language publications through to April 25, 2021. Full‐text articles evaluating escalated maintenance treatment (infliximab or adalimumab) in adult CD patients were included. Results A total of 4733 records were identified, and 68 articles met eligibility criteria. Rates of clinical response (33%‐100%) and remission (15%‐83%) after empiric dose escalation for loss of response to standard anti‐TNF therapy were high but varied across studies. Dose intensification strategies (doubling the dose versus shortening the therapeutic interval) were similarly efficacious. Dose‐escalated patients tended to have higher serum drug levels compared to those on standard dosing. An exposure‐response relationship following dose escalation was found in a number of observational studies. Randomised controlled trials comparing therapeutic drug monitoring (TDM) to empiric treatment intensification have failed to reach their primary end‐points. Strategies including Bayesian dashboard‐dosing and early treatment escalation targeting biomarker normalisation were found to be associated with improved long‐term outcomes. Conclusions Empiric escalation of maintenance anti‐TNF therapy can recapture clinical response in a majority of patients with secondary loss of response to standard maintenance doses. Proactive optimisation of maintenance dosing might prolong time to loss of response in some patients.

show abstract

“…Thiopurines and methotrexate are less effective than tumor necrosis factor (TNF)-alpha inhibitors in long-term maintenance of remission (15). The sustained clinical response to TNF-alpha inhibitors is observed in approximately 60% of the patients (16), and high infliximab levels are associated with higher rates of clinical, laboratory, endoscopic, and radiological remission in adults with CD (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Clinical Relapses in Pediatric Luminal Crohn's Disease: A Retrospective Cohort Study

et al. 2022

View full text Add to dashboard Cite

INTRODUCTION:There is currently little knowledge on factors associated with the relapse of Crohn's disease (CD) in children. The aims of this study were to describe the risk factors associated with relapse in pediatric CD and the changes in the relapse rate over the past decade.METHODS:Patients younger than 18 years and diagnosed between 2009 and 2019 were included in this retrospective cohort study. Clinical, endoscopic, histological, and laboratory data, as well as induction and maintenance treatments, were collected from the medical records. Survival analyses and Cox regression models were used to assess the impact of these risk factors on relapse.RESULTS:Six hundred thirty-nine patients were included. There was a decrease in the clinical relapse rate over the past decade: 70.9% of the patients diagnosed between 2009 and 2014 relapsed as compared with 49.1% of the patients diagnosed between 2015 and 2019 (P < 0.0001). The following variables were associated with clinical relapse: female sex (adjusted hazard ratio [aHR] = 1.52, P = 0.0007), exposure to oral 5-ASA (aHR = 1.44, P = 0.04), use of immunomodulatory agents compared with tumor necrosis factor-alpha inhibitors (methotrexate aHR = 1.73, P = 0.003; thiopurines aHR = 1.63, P = 0.002), presence of granulomas (aHR = 1.34, P = 0.02) and increased eosinophils on intestinal biopsies (aHR = 1.36, P = 0.02), high levels of C-reactive protein (aHR = 1.01, P < 0.0001) and fecal calprotectin (aHR = 1.08, P < 0.0001), and low serum infliximab levels (aHR = 2.32, P = 0.001).DISCUSSION:Relapse of pediatric CD has decreased in the past decade. The risk of relapse is significantly associated with clinical, endoscopic, histological, and laboratory variables and treatment strategies.

show abstract

Infliximab Exposure Associates With Radiologic Evidence of Healing in Patients With Crohn’s Disease

Cited by 20 publications

References 28 publications

Editorial: crystal gazing with magnetic resonance enterography to predict the response to TNF‐alpha inhibitors in Crohn's disease

Editorial: crystal gazing with magnetic resonance enterography to predict the response to TNF‐alpha inhibitors in Crohn's disease

Systematic review: efficacy of escalated maintenance anti‐tumour necrosis factor therapy in Crohn's disease

Risk Factors of Clinical Relapses in Pediatric Luminal Crohn's Disease: A Retrospective Cohort Study

Contact Info

Product

Resources

About