ASSESSMENT OF LOSS OF RESPONSE TO INFLIXIMAB THERAPY IN INFLAMMATORY BOWEL DISEASES USING ANTIBODIES TO INFLIXIMAB AND TROUGH LEVELS
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1
Università Cattolica del Sacro Cuore, Italy
Currently the management of inflammatory bowel disease (IBD) patients on infliximab therapy who lose response is mostly empirical: an increase of dose up to double or a decrease of treatment intervals is the common clinical practice, with a consequent increase of drug use and high costs. Measuring trough levels (TL) and antibodies to infliximab (ATI) may be of great benefit in optimizing therapy. We aimed to evaluate the relationship of TL and ATI assay with loss of response and infusion reactions in an Italian IBD unit.
Methods: Sera were obtained from 82 IBD patients on infliximab maintenance therapy from at least 6 months. Patients were classified as being or not in clinical response. The occurrence of acute reactions to infliximab infusions was recorded. ATI and TL were measured by a commercial ELISA (Immundiagnostik AG, Bernsheim, Germany).
Results: ATI were detected in 18 patients (22%), 50% of which were in clinical response as compared to 80% of patients without detectable serum ATI levels (p=0.0271 by χ2 test). 5/18 (28%) of ATI positive patients had infusion reactions as compared to 2/64 (3%) ATI negative (p=0.0047 by χ2 test). 60/82 patients had infliximab TL >0,1 µg/ml and 80% of them were in clinical response, as compared with 54% of patients with TL lower than 0,1 ug/ml (p=0.0043 by χ2 test). Median TL were not significantly different among clinical responders and non-responders.
Conclusion: The combination of ATI and infliximab TL assay could help in managing loss of clinical response in IBD.
Keywords:
Inflammatory Bowel Diseases,
infliximab,
anti drug antibodies,
Crohn's disease,
ulcerative colitis
Conference:
15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013.
Presentation Type:
Abstract
Topic:
Translational immunology and immune intervention
Citation:
Guidi
L,
Andrisani
G,
Marzo
M,
Papa
A,
Felice
C,
Pugliese
D,
Canestri
S,
Tolusso
B,
Gremese
E and
Armuzzi
A
(2013). ASSESSMENT OF LOSS OF RESPONSE TO INFLIXIMAB THERAPY IN INFLAMMATORY BOWEL DISEASES USING ANTIBODIES TO INFLIXIMAB AND TROUGH LEVELS.
Front. Immunol.
Conference Abstract:
15th International Congress of Immunology (ICI).
doi: 10.3389/conf.fimmu.2013.02.00736
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Received:
14 Jun 2013;
Published Online:
22 Aug 2013.
*
Correspondence:
Prof. Luisa Guidi, Università Cattolica del Sacro Cuore, Roma, Italy, lguidi@rm.unicatt.it