Clinical role, optimal timing and frequency of serum infliximab and anti-infliximab antibody level measurements in patients with inflammatory bowel disease

Renáta Bor, Klaudia Farkas, Anna Fábián, Anita Bálint, Ágnes Milassin, Mariann Rutka, Mária Matuz, Ferenc Nagy, Zoltán Szepes, T. Molnár

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Serum infliximab (IFX) and antibody-to-infliximab (ATI) levels are objective parameters, that may have a great role in the therapeutic decisions during maintenance biological therapy. Research design and methods: 48 inflammatory bowel disease patients receiving maintenance IFX therapy were prospectively enrolled and divided into adequate (complete remission N =20) and inadequate responder (partial response, loss of response, dose escalation; N =28) groups. Blood samples were collected just before (trough level, TL) and two (W2aTL) and six weeks (W6aTL) after the administration of IFX. Results: Single measurement of ATI titer was insufficient for predicting therapeutic response due to transient expression of ATI, however, using the three points' measurements, significant difference has been detected between the adequate and inadequate responder group (5.0% vs 35.7%; p =0.016). The mean value of TL was significantly higher in the adequate responder group (3.11±1.64 vs.1.19±1.11; p<0.001) without further difference on the second and sixth week. Sensitivity and specificity for predicting the therapeutic response were 85.0% and 71.4% based on the cut-off value of TL 2.0 μg/ml. Conclusion: Simultaneous measurement of serum IFX level prior to administration of regular IFX infusion and ATI titers significantly increase the diagnostic accuracy for the therapeutic decision in patients uncertainly responding to the therapy. The measurement of W2aTL and W6aTL levels did not result in further improvement in the prediction of therapeutic response.

Original languageEnglish
Article numbere0172916
JournalPLoS One
Volume12
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

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Level measurement
inflammatory bowel disease
blood serum
Inflammatory Bowel Diseases
Anti-Idiotypic Antibodies
therapeutics
antibodies
Antibodies
Serum
Therapeutics
Maintenance
Infliximab
remission
Biological Therapy
dose response
Blood
Research Design
prediction
Sensitivity and Specificity
blood

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Clinical role, optimal timing and frequency of serum infliximab and anti-infliximab antibody level measurements in patients with inflammatory bowel disease. / Bor, Renáta; Farkas, Klaudia; Fábián, Anna; Bálint, Anita; Milassin, Ágnes; Rutka, Mariann; Matuz, Mária; Nagy, Ferenc; Szepes, Zoltán; Molnár, T.

In: PLoS One, Vol. 12, No. 3, e0172916, 01.03.2017.

Research output: Contribution to journalArticle

Bor, Renáta ; Farkas, Klaudia ; Fábián, Anna ; Bálint, Anita ; Milassin, Ágnes ; Rutka, Mariann ; Matuz, Mária ; Nagy, Ferenc ; Szepes, Zoltán ; Molnár, T. / Clinical role, optimal timing and frequency of serum infliximab and anti-infliximab antibody level measurements in patients with inflammatory bowel disease. In: PLoS One. 2017 ; Vol. 12, No. 3.
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AU - Bor, Renáta

AU - Farkas, Klaudia

AU - Fábián, Anna

AU - Bálint, Anita

AU - Milassin, Ágnes

AU - Rutka, Mariann

AU - Matuz, Mária

AU - Nagy, Ferenc

AU - Szepes, Zoltán

AU - Molnár, T.

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N2 - Background: Serum infliximab (IFX) and antibody-to-infliximab (ATI) levels are objective parameters, that may have a great role in the therapeutic decisions during maintenance biological therapy. Research design and methods: 48 inflammatory bowel disease patients receiving maintenance IFX therapy were prospectively enrolled and divided into adequate (complete remission N =20) and inadequate responder (partial response, loss of response, dose escalation; N =28) groups. Blood samples were collected just before (trough level, TL) and two (W2aTL) and six weeks (W6aTL) after the administration of IFX. Results: Single measurement of ATI titer was insufficient for predicting therapeutic response due to transient expression of ATI, however, using the three points' measurements, significant difference has been detected between the adequate and inadequate responder group (5.0% vs 35.7%; p =0.016). The mean value of TL was significantly higher in the adequate responder group (3.11±1.64 vs.1.19±1.11; p<0.001) without further difference on the second and sixth week. Sensitivity and specificity for predicting the therapeutic response were 85.0% and 71.4% based on the cut-off value of TL 2.0 μg/ml. Conclusion: Simultaneous measurement of serum IFX level prior to administration of regular IFX infusion and ATI titers significantly increase the diagnostic accuracy for the therapeutic decision in patients uncertainly responding to the therapy. The measurement of W2aTL and W6aTL levels did not result in further improvement in the prediction of therapeutic response.

AB - Background: Serum infliximab (IFX) and antibody-to-infliximab (ATI) levels are objective parameters, that may have a great role in the therapeutic decisions during maintenance biological therapy. Research design and methods: 48 inflammatory bowel disease patients receiving maintenance IFX therapy were prospectively enrolled and divided into adequate (complete remission N =20) and inadequate responder (partial response, loss of response, dose escalation; N =28) groups. Blood samples were collected just before (trough level, TL) and two (W2aTL) and six weeks (W6aTL) after the administration of IFX. Results: Single measurement of ATI titer was insufficient for predicting therapeutic response due to transient expression of ATI, however, using the three points' measurements, significant difference has been detected between the adequate and inadequate responder group (5.0% vs 35.7%; p =0.016). The mean value of TL was significantly higher in the adequate responder group (3.11±1.64 vs.1.19±1.11; p<0.001) without further difference on the second and sixth week. Sensitivity and specificity for predicting the therapeutic response were 85.0% and 71.4% based on the cut-off value of TL 2.0 μg/ml. Conclusion: Simultaneous measurement of serum IFX level prior to administration of regular IFX infusion and ATI titers significantly increase the diagnostic accuracy for the therapeutic decision in patients uncertainly responding to the therapy. The measurement of W2aTL and W6aTL levels did not result in further improvement in the prediction of therapeutic response.

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