scholarly journals TNF Blocking Therapies and Immunomonitoring in Patients with Inflammatory Bowel Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
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.

scholarly journals Infliximab Trough Levels and Quality of Life in Patients with Inflammatory Bowel Disease in Maintenance Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Rogério S. Parra ◽  
Marley R. Feitosa ◽  
Letícia C. H. Ribeiro ◽  
Lais A. Castro ◽  
José J. R. Rocha ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Maintenance Therapy ◽  
Bowel Disease ◽  
Clinical Remission ◽  
Mucosal Healing ◽  
Mayo Score ◽  
Inflammatory Bowel ◽  
Trough Levels

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.

scholarly journals Management of COVID-19 Pandemic in Spanish Inflammatory Bowel Disease Units: Results From a National Survey

2020 ◽  
Author(s):  
Eduardo Martin Arranz ◽  
Cristina Suarez Ferrer ◽  
Laura García Ramírez ◽  
Jose Luis Rueda García ◽  
María Sánchez-Azofra ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
National Survey ◽  
Bowel Disease ◽  
Health Centers ◽  
Protective Measures ◽  
Chest X Ray ◽  
Inflammatory Bowel ◽  
Polymerase Chain ◽  
Necrosis Factor

Abstract Background The outbreak of COVID-19 has rapidly evolved into a pandemic that has represented a challenge to health systems worldwide. Inflammatory bowel disease (IBD) units have been forced to change their practices to address the disease and to ensure the quality of care. Methods We conducted a national survey among IBD gastroenterologist members of the Spanish Working Group on Crohn’s Disease and Colitis regarding changes of practice, IBD treatments, and diagnosis and treatment of COVID-19. Results We received 54 answers from Spanish hospitals. One hundred percent of the IBD units rescheduled onsite visits to telematic consultation, and elective endoscopic and surgical procedures were delayed. Protective measures were also taken in the infusion units (100% of health centers) and hospital pharmacies, with 40.7% sending subcutaneous medications to patients. No switching between intravenous and subcutaneous anti-tumor necrosis factor drugs were made. We also found that 96.1% of IBD units advised their patients to maintain treatment if they were asymptomatic for COVID-19. For patients with COVID-19 symptoms, 92.6% of IBD units referred them to primary care or the emergency department. In addition, 7.5% of IBD units made a COVID-19 diagnosis through polymerase chain reaction and/or chest x-ray. Modifications in IBD treatment and treatment recommended for COVID-19 are also discussed. Conclusions We report a representative national survey of changes made in the structure, diagnosis of COVID-19, and modifications in IBD treatments within IBD units.

scholarly journals P454 Early vedolizumab trough levels predict mucosal healing in inflammatory bowel disease

2018 ◽  
Vol 12 (supplement_1) ◽  
pp. S334-S334
Author(s):  
W Yacoub ◽  
N Williet ◽  
L Pouillon ◽  
T Di-Bernado ◽  
M De Carvalho Bittencourt ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Mucosal Healing ◽  
Inflammatory Bowel ◽  
Trough Levels

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

2012 ◽  
Vol 24 (7) ◽  
pp. 762-769 ◽  
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

scholarly journals Serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel disease

2021 ◽  
Vol 8 (1) ◽  
pp. e000788
Author(s):  
Shaina Sekhri ◽  
Bharat Rao ◽  
Akanksha Mohananey ◽  
Poonam Beniwal-Patel ◽  
Alexandra Bruss ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Therapeutic Drug ◽  
Extraintestinal Manifestation ◽  
Cross Sectional ◽  
Patient Reported ◽  
Serum Trough ◽  
Inflammatory Bowel ◽  
Trough Levels ◽  
Serum Trough Levels

BackgroundInfliximab is an efficacious therapy for inflammatory bowel disease and may play a role in management of some extraintestinal manifestations. While higher trough levels of infliximab are associated with higher rates of disease remission, the association between trough levels of infliximab and arthralgia activity characterised as an extraintestinal manifestation has yet to be defined.ObjectiveWe aimed to assess the association between serum trough levels of infliximab and peripheral arthralgia activity in patients with inflammatory bowel disease.DesignIn this cross-sectional study, we identified patients with inflammatory bowel disease on infliximab therapy with known history of arthralgias attributed to an extraintestinal manifestation. Collected variables included disease phenotype, medications (such as thiopurines or methotrexate), Harvey Bradshaw Index, partial Mayo score, C reactive protein, trough levels of infliximab and anti-infliximab antibodies. The primary outcome was active patient-reported arthralgia.ResultsOut of 267 patients included, 65 (24.4%) had active arthralgias at the time the trough level of infliximab was measured. No significant differences in trough levels were seen between those patients with and without arthralgias. Patients on combination therapy with methotrexate or thiopurines or those with detectable anti-infliximab antibodies were not more likely to have inactive arthralgias (OR 0.99, 95% CI 0.57 to 1.74, p=0.99 and OR 1.94, 95% CI 0.9 to 4.1, p=0.09, respectively).ConclusionsThis study suggests that although therapeutic drug monitoring of infliximab can have a role in the management of Crohn’s disease and ulcerative colitis, it does not seem to be useful in managing arthralgias associated with inflammatory bowel disease.

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