Document Detail


Trough infliximab concentrations predict efficacy and sustained control of disease activity in rheumatoid arthritis.
MedLine Citation:
PMID:  20216124     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Infliximab is a chimeric monoclonal antibody that binds to human tumor necrosis factor alpha and is approved for refractory rheumatoid arthritis. We studied the association between infliximab concentration and long-term control of disease activity in patients with rheumatoid arthritis treated on a routine basis both in cross-sectional analysis and over the long term. Trough serum infliximab concentrations were measured in patients with rheumatoid arthritis receiving infliximab infusions during the period August to October 2006. Disease activity was assessed by the Disease Activity Score for 28 Joints (DAS28) and usual biologic markers. During a 42-week follow-up period, patients were classified into two groups: those continuing with the same or lower doses of infliximab (Group A = treatment success) and those who switched to another biopharmaceutical or required an increase in infliximab dose (Group B = treatment failure). Treatment maintenance for Group A was analyzed by categories of infliximab concentration at baseline and compared by the log rank test. In 28 patients, C-reactive protein and infliximab concentrations were inversely related. Infliximab concentration in patients with low disease activity (DAS28 3.2 or less) was higher than in those with persistent active disease (DAS28 greater than 3.2); median values were 3.26 and 0.16 mg/L, respectively (P < 0.01). Analysis after 42 weeks showed that patients in Group A had higher infliximab concentrations at baseline than those with treatment failure (P < 0.01). In rheumatoid arthritis, infliximab concentration is predictive of sustained efficacy with the same infliximab regimen and should be considered on a routine basis.
Authors:
Denis Mulleman; Delphine Chu Miow Lin; Emilie Ducourau; Patrick Emond; David Ternant; Charlotte Magdelaine-Beuzelin; Jean-Pierre Valat; Gilles Paintaud; Philippe Goupille
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Therapeutic drug monitoring     Volume:  32     ISSN:  1536-3694     ISO Abbreviation:  Ther Drug Monit     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7909660     Medline TA:  Ther Drug Monit     Country:  United States    
Other Details:
Languages:  eng     Pagination:  232-6     Citation Subset:  IM    
Affiliation:
Université François Rabelais de Tours, CNRS, UMR 6239, Tours, France. mulleman@univ-tours.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal / administration & dosage*,  blood*
Arthritis, Rheumatoid / blood*,  drug therapy*
Cross-Sectional Studies
Delayed-Action Preparations / administration & dosage,  pharmacokinetics
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Delayed-Action Preparations; 0/infliximab

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