Publication Date:
2019
Description:
Abstract
This study aimed at exploring the link between individual concentrations, pharmacokinetic parameters and the probability of relapse after de‐escalation in a real‐world prospective cohort of IBD patients who underwent infliximab treatment de‐escalation. Ninety‐one patients were included. A time‐varying compartment model was used to estimate individual pharmacokinetic parameters and trough concentrations. A Cox model was implemented to explore the parameters influencing the probability of relapse after de‐escalation. Volume, clearance, and trough before and after de‐escalation were linked to the relapse risk at the univariate step. Independent predictors of relapse were tobacco use and/or ulcerative colitis (p=0.0093), a higher C‐Reactive Protein (p=0.00064), an infliximab trough 〈2.4 μg/mL after de‐escalation (p=0.0001). Patients with trough 〉5.7μg/mL are eligible to de‐escalation, but infliximab pharmacokinetics is highly variable in time. Therefore, drug monitoring is mandatory after de‐escalation to maintain trough 〉2.4μg/mL. Clearance monitoring seem an appealing approach for patient selection and relapse prediction.
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Print ISSN:
0009-9236
Electronic ISSN:
1532-6535
Topics:
Chemistry and Pharmacology
,
Medicine
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