Year 2020 / Volume 112 / Number 10
Original
Cut-off ranges of infliximab serum levels in Crohn’s disease in the clinical practice

756-761

DOI: 10.17235/reed.2020.6539/2019

Teresa Valdés Delgado, María Fernanda Guerra Veloz, Luisa Castro Laria, Belén Maldonado Pérez, Raúl Perea Amarillo, Vicente Merino Bohórquez, Antonia Sáez, Ángel Caunedo Álvarez, Federico Argüelles Arias,

Abstract
Introduction: between 30 % and 40 % of patients treated with infliximab lose response during maintenance. Therapeutic drug monitoring could be used to optimize management in these situations. However, infliximab serum levels are not well defined. The aim of this study was to determine the cut-off range of infliximab serum levels in Crohn’s disease patients in remission in the clinical practice. Methods: an observational retrospective study was performed from 2016 to 2017. Patients were included with established Crohn’s disease, who had been on a maintenance dose schedule of infliximab. Infliximab levels and antibodies to infliximab were measured at least twice in all patients, after induction and after six months of treatment. Clinical remission was defined as ≤ 4 using the Harvey-Bradshaw index. Cluster analysis was used to analyze the results. Results: one hundred and five Crohn’s disease patients were included in the study; 57.1 % were male with a mean age of 39 years (SD ± 12.9). The median (range) time of the disease was eleven years (7-15) and the median (range) time of follow-up was 32 months (22-38). Patients who achieved remission had infliximab serum levels between 4.26-8.26 ug/ml versus 0.06-1.43 ug/ml in patients who did not achieve remission after induction. Infliximab serum levels were 2.84-7.75 ug/ml and 0.05-2.69 ug/ml in patients who achieved remission versus those who did not achieve remission after six months of treatment. Overall, 4.26-8.26 ug/ml was found to be the best cut-off range for remission. Conclusions: in our clinical practice, serum levels of infliximab in Crohn’s disease patients should be higher than 4 ug/ml to achieve clinical remission.
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Valdés Delgado T, Guerra Veloz M, Castro Laria L, Maldonado Pérez B, Perea Amarillo R, Merino Bohórquez V, et all. Cut-off ranges of infliximab serum levels in Crohn’s disease in the clinical practice. 6539/2019


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Publication history

Received: 29/07/2019

Accepted: 23/01/2020

Online First: 21/09/2020

Published: 07/10/2020

Article revision time: 164 days

Article Online First time: 420 days

Article editing time: 436 days


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