Sa1742 Higher Infliximab Trough Levels Are Associated With Mucosal Healing and Improved Quality of Life in Patients With Inflammatory Bowel Disease

Objective. Investigate the association between infliximab trough levels and quality of life in inflammatory bowel disease patients in maintenance therapy. Methods. We carried out a transversal study with inflammatory bowel disease patients in infliximab maintenance therapy. Infliximab trough levels were determined using a quantitative rapid test. Disease activity indices (partial Mayo Score and Harvey-Bradshaw Index) and endoscopic scores (endoscopic Mayo Score or Simple Endoscopic Score in Crohn’s disease) were obtained. Quality of life was assessed using the Inflammatory Bowel Disease Questionnaire (IBDQ). Results. Seventy-one consecutive subjects were included in the study (55 with Crohn’s disease and 16 with ulcerative colitis). Drug levels were considered satisfactory (≥3 μg/mL) in 28 patients (39.4%) and unsatisfactory (<3 μg/mL) in 43 (60.6%). Satisfactory trough levels were associated with higher rates of clinical remission and mucosal healing. Higher trough levels were also associated with improved IBDQ scores, particularly regarding bowel symptoms, systemic function, and social function. Conclusion. Satisfactory trough levels of infliximab were associated with higher rates of clinical remission, mucosal healing, and improved quality of life in inflammatory bowel disease patients on maintenance therapy.

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Mucosal healing restores normal health and quality of life in patients with inflammatory bowel disease

European Journal of Gastroenterology & Hepatology ◽

10.1097/meg.0b013e32835414b2 ◽

2012 ◽

Vol 24 (7) ◽

pp. 762-769 ◽

Cited By ~ 54

Author(s):

Francesc Casellas ◽

Manuel Barreiro de Acosta ◽

Marta Iglesias ◽

Virginia Robles ◽

Pilar Nos ◽

...

Keyword(s):

Quality Of Life ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Mucosal Healing ◽

Inflammatory Bowel ◽

Normal Health

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Self-assessment of treatment targets in patients with inflammatory bowel disease using a survey

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284820971213 ◽

2020 ◽

Vol 13 ◽

pp. 175628482097121

Author(s):

Philipp A. Reuken ◽

Philip C. Grunert ◽

Andreas Lügering ◽

Niels Teich ◽

Andreas Stallmach

Keyword(s):

Quality Of Life ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Mucosal Healing ◽

Self Assessment ◽

Treatment Targets ◽

Inflammatory Bowel ◽

Typical Treatment ◽

Adherence To Therapy

Background: Physicians can improve their relationships with patients by understanding and meeting patients’ treatment targets, leading to higher adherence to therapy and improved disease prognosis. In the current study, we performed a questionnaire-based survey to further understand treatment targets in patients with inflammatory bowel disease (IBD). Methods: We created a questionnaire based on a point-allocation scale with 10 treatment target items. A total of 234 patients with IBD [Crohn’s disease ( n = 129) and ulcerative colitis ( n = 105)] participated in three German IBD centers. Patients were asked to allocate a total of 10 points across the 10 items, with more points indicating more importance. Results: The most important treatment targets for patients regarding their therapy were quality of life (2.78 points), control of defecation (1.53 points), and avoidance of IBD-related surgery (1.69 points). Avoiding surgery for IBD was less important in patients who had already undergone a surgical procedure than in those who had not (1.26 points versus 1.89 points, p < 0.001). Typical treatment targets, including mucosal healing (0.52 points) and normal biochemical markers (0.39 points), were not scored high by patients. The least important item was the possibility of all-oral therapy (0.19 points in 33 patients, 0 points in 201 patients). Conclusion: Treatment targets for patients were primarily related to quality of life, such as therapy side effects. Knowing these targets may improve patient–physician relationships and communication, and consequently, adherence to therapy.

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Switching from originator infliximab to the biosimilar CT-P13 in 313 patients with inflammatory bowel disease

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284818801244 ◽

2018 ◽

Vol 11 ◽

pp. 175628481880124 ◽

Cited By ~ 12

Author(s):

Viktoria Bergqvist ◽

Mohammad Kadivar ◽

Daniel Molin ◽

Leif Angelison ◽

Per Hammarlund ◽

...

Keyword(s):

Quality Of Life ◽

Inflammatory Bowel Disease ◽

Adverse Events ◽

Disease Activity ◽

Bowel Disease ◽

Clinical Disease ◽

Clinical Disease Activity ◽

Inflammatory Bowel ◽

Trough Levels

Background: As the patents of originator biologics are expiring, biosimilar versions are becoming available for the treatment of inflammatory bowel disease (IBD). However, published switch studies of the first infliximab biosimilar, CT-P13, have delivered ambiguous results that could be interpreted as showing a trend towards inferior effectiveness in Crohn’s disease (CD) compared with ulcerative colitis (UC). The aim of this study was to investigate the effectiveness and safety of switching IBD patients from treatment with Remicade to CT-P13. Methods: In this prospective observational cohort study, all adult IBD patients on Remicade treatment, at four hospitals, were switched to CT-P13. The primary endpoint was change in clinical disease activity at 2, 6, and 12 months after the switch. Secondary endpoints were subgroup analyses of patients with and without concomitant immunomodulators; changes in biomarkers, quality of life, drug trough levels and anti-drug antibodies (ADAbs); and adverse events. Results: A total of 313 IBD patients were switched (195 CD; 118 UC). There were no significant changes in clinical disease activity, quality of life, biomarkers (except a small but significant increase in albumin in CD) including F-calprotectin, drug trough levels, or proportion of patients in remission. Disease worsening rates were 14.0% for CD and 13.8% for UC; and 2.7% developed ADAbs and 2.2% developed serious adverse events. Conclusions: This is the largest study of switched IBD patients published to date, and it demonstrates that switching from Remicade to CT-P13 may be done with preserved therapeutic effectiveness and safety in both CD and UC.

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TNF Blocking Therapies and Immunomonitoring in Patients with Inflammatory Bowel Disease

Mediators of Inflammation ◽

10.1155/2014/172821 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 18

Author(s):

Romain Altwegg ◽

Thierry Vincent

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Mucosal Healing ◽

Primary Resistance ◽

Current State ◽

Serum Trough ◽

Inflammatory Bowel ◽

Trough Levels ◽

Necrosis Factor

Since their appearance in the armamentarium for inflammatory bowel disease (IBD) more than a decade ago, antitumor necrosis factor (TNF) inhibitors have demonstrated beneficial activity in induction and maintenance of clinical remission, mucosal healing, improvement in quality of life, and reduction in surgeries and hospitalizations. However, more than one-third of patients present primary resistance, and another one-third become resistant over time. One of the main factors associated with loss of response is the immunogenicity of anti-TNF biologics leading to the production of antidrug antibodies (ADAbs) accelerating their clearance. In this review we present the current state of the literature on the place of TNF and its blockage in the treatment of patients with IBD and discuss the usefulness of serum trough levels and ADAb monitoring in the optimization of anti-TNF therapies.

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