Therapeutic drug monitoring of infliximab in spondyloarthritis: an observational open-label study.

Abstract:

BACKGROUND:Infliximab is a chimeric monoclonal antibody that binds to human tumor necrosis factor alpha and which is approved for refractory spondyloarthritis (SpA). Individual adjustment of infliximab dosage may help to improve the therapeutic response in SpA. We investigated whether a knowledge of infliximab serum concentration modifies physician decision and improves the control of disease activity in SpA. METHODS:Thirty-two patients routinely treated with infliximab were included in an observational open-label study. On visit 1 (V1), according to disease activity, a preliminary therapeutic decision was selected among 4 therapeutic options (ie, decrease, increase, maintain the dosage of infliximab, or switch over for another treatment), and a blood sample was collected to measure infliximab trough serum concentration. The final therapeutic decision, based on both disease activity and infliximab serum concentration assessed at V1, was applied at the following infusion (V2). Clinical and biological evaluations were performed at V3 and V4 and compared with those at V1. RESULTS:The measurement of infliximab trough concentration modified the therapeutic decision for 10 patients (31%). For both patients with increased or decreased infliximab dosage at V2, median Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was similar at V3 or V4 as compared with that at V1. However, a trend for an inverse relationship between infliximab serum concentrations and BASDAI was observed. CONCLUSIONS:Knowledge of infliximab trough concentration modified the therapeutic decision for SpA patients with predominantly axial symptoms but did not improve the control of disease activity as estimated by the BASDAI.

journal_name

Ther Drug Monit

authors

Méric JC,Mulleman D,Ducourau E,Lauféron F,Miow Lin DC,Watier H,Goupille P,Paintaud G

doi

10.1097/FTD.0b013e318224f83d

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

411-6

issue

4

eissn

0163-4356

issn

1536-3694

journal_volume

33

pub_type

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