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Bratislava Medical Journal Vol.124, No.7, p.485–492, 2023 |
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Title: Predictive value of infliximab trough levels in maintenance therapy for 5-year sustained clinical remission in patients with inflammatory bowel disease | ||
Author: Yashar JALALI, Anna GOJDICOVA, Igor STURDIK, Jozef TOTH, Tomas KOLLER, Martin HUORKA, Monika JALALI, Juraj PAYER, Tibor HLAVATY | ||
Abstract: BACKGROUND: Despite long-term use of infliximab (IFX) in IBD treatment, its optimized use is unclear due to its complicated pharmacokinetics/dynamics. Hence, the predictive value of IFX trough levels (TL) is important in treatment management. METHODS: We performed a prospective, cross-sectional, observational study with 74 IBD patients treated with IFX (mean 9.1 years, SD ± 3). TL was measured during maintenance therapy, in which maintenance of remission was followed for 5 years. RESULTS: TL > 3 µg/ml during maintenance therapy was a significant predictor of clinical remission in 5 years in UC patients (82 % vs 62 %, p 3 µg/ml during maintenance therapy in a cohort of IBD patients (p = 0.05). Deviations in percentage of remission and fraction of relapses in TL categories were insignificant in a cohort of CD patients (85 % vs 74 %, p > 0.05). CONCLUSIONS: TL > 3 µg/ml during maintenance therapy is a strong predictor of sustained clinical remission for 5 years in UC patients. The use of combination therapy with AZA, due to its significant association with high TL, may have a practical benefit in achieving better clinical outcomes in UC patients (Tab. 2, Fig. 10, Ref. 20). |
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Keywords: trough levels, inflammatory bowel disease, ulcerative colitis, Crohn’s disease, infliximab, therapeutic drug monitoring. | ||
Published online: 12-May-2023 | ||
Year: 2023, Volume: 124, Issue: 7 | Page From: 485, Page To: 492 | |
doi:10.4149/BLL_2023_074 |
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