Low Dose Infliximab for Prevention of Postoperative Recurrence of Crohn's Disease: Long Term Follow-Up and Impact of Infliximab Trough Levels and Antibodies to Infliximab
In patients with postoperative recurrence of Crohn's disease endoscopic and clinical remission can be maintained for up to 1 year with low infliximab doses (3 mg/Kg). However, in theory low-dose infliximab treated patients could develop subtherapeutic trough levels, infiximab antibodies, and mi...
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| description | In patients with postoperative recurrence of Crohn's disease endoscopic and clinical remission can be maintained for up to 1 year with low infliximab doses (3 mg/Kg). However, in theory low-dose infliximab treated patients could develop subtherapeutic trough levels, infiximab antibodies, and might loose response to therapy. To verify this hypothesis infliximab pharmacokinetics and clinical/endoscopic response were checked in a group of patients treated in the long term with low infliximab doses.
Infliximab antibodies, infliximab levels, highly-sensitive CRP and fecal calprotectin were measured during the 8-week interval in 5 consecutive patients in clinical (Crohn's Disease Activity Index < 150) and endoscopic (Rutgeerts scores 0-1) remission after one year of therapy with infliximab 3 mg/Kg. For comparison with reported standards, infliximab pharmacokinetics and inflammatory parameters were also tested in 6 Crohn's disease patients who did not undergo surgery and who were in clinical remission while on infliximab 5 mg/Kg. Patients on low infliximab dose also underwent colonoscopy after 18 additional months of therapy.
Highly sensitive CRP and fecal calprotectin increased in all patients during the 8-week interval. Infliximab trough levels were lower in patients treated with the low dose compared to controls (mean±SE: 2.0±0.3 vs 4.75±0.83 μg/mL respectively p |
| doi_str_mv | 10.1371/journal.pone.0144900 |
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Infliximab antibodies, infliximab levels, highly-sensitive CRP and fecal calprotectin were measured during the 8-week interval in 5 consecutive patients in clinical (Crohn's Disease Activity Index < 150) and endoscopic (Rutgeerts scores 0-1) remission after one year of therapy with infliximab 3 mg/Kg. For comparison with reported standards, infliximab pharmacokinetics and inflammatory parameters were also tested in 6 Crohn's disease patients who did not undergo surgery and who were in clinical remission while on infliximab 5 mg/Kg. Patients on low infliximab dose also underwent colonoscopy after 18 additional months of therapy.
Highly sensitive CRP and fecal calprotectin increased in all patients during the 8-week interval. Infliximab trough levels were lower in patients treated with the low dose compared to controls (mean±SE: 2.0±0.3 vs 4.75±0.83 μg/mL respectively p<0.05). Infliximab antibodies were present in two of the subjects treated with low infliximab dose and in none of the controls. However, in low dose-treated patients after 18 additional months of therapy endoscopy continued to show mucosal remission and none of them developed clinical recurrence or side effects.
Patients treated with low infliximab doses had lower trough levels compared to patients treated with 5 mg/Kg and some developed antibodies to infliximab. However, low infliximab doses sustained clinical and endoscopic remission for a total of 30 months of treatment.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0144900</identifier><identifier>PMID: 26670274</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Analysis ; Antibodies ; Biomarkers - metabolism ; C-Reactive Protein - metabolism ; Care and treatment ; Case-Control Studies ; Colon ; Colonoscopy ; Complications and side effects ; Crohn Disease - drug therapy ; Crohn Disease - prevention & control ; Crohn Disease - surgery ; Crohn's disease ; Crohns disease ; Dosage and administration ; Dose-Response Relationship, Drug ; Drug dosages ; Drug therapy ; Endoscopy ; Enrollments ; Feces - chemistry ; Female ; Follow-Up Studies ; Gastroenterology ; Humans ; Immunoglobulins ; Immunotherapy ; Inflammation ; Inflammatory bowel disease ; Infliximab ; Infliximab - immunology ; Infliximab - pharmacokinetics ; Infliximab - therapeutic use ; Leukocyte L1 Antigen Complex - metabolism ; Male ; Medicine ; Middle Aged ; Monoclonal antibodies ; Mucosa ; Patients ; Pharmacokinetics ; Pharmacology ; Postoperative Period ; Prevention ; Prognosis ; Recurrence ; Recurrence (Disease) ; Remission ; Risk factors ; Side effects ; Surgery ; Systematic review ; Therapy ; Tumor necrosis factor-TNF ; Tumor necrosis factor-α</subject><ispartof>PloS one, 2015-12, Vol.10 (12), p.e0144900-e0144900</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Sorrentino et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Sorrentino et al 2015 Sorrentino et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-9543a3b3aaf748bf91873de5fd864c3bf6ddb65668ae26b8520954ece90e55443</citedby><cites>FETCH-LOGICAL-c692t-9543a3b3aaf748bf91873de5fd864c3bf6ddb65668ae26b8520954ece90e55443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4680060/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4680060/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26670274$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sorrentino, Dario</creatorcontrib><creatorcontrib>Marino, Marco</creatorcontrib><creatorcontrib>Dassopoulos, Themistocles</creatorcontrib><creatorcontrib>Zarifi, Dimitra</creatorcontrib><creatorcontrib>Del Bianco, Tiziana</creatorcontrib><title>Low Dose Infliximab for Prevention of Postoperative Recurrence of Crohn's Disease: Long Term Follow-Up and Impact of Infliximab Trough Levels and Antibodies to Infliximab</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>In patients with postoperative recurrence of Crohn's disease endoscopic and clinical remission can be maintained for up to 1 year with low infliximab doses (3 mg/Kg). However, in theory low-dose infliximab treated patients could develop subtherapeutic trough levels, infiximab antibodies, and might loose response to therapy. To verify this hypothesis infliximab pharmacokinetics and clinical/endoscopic response were checked in a group of patients treated in the long term with low infliximab doses.
Infliximab antibodies, infliximab levels, highly-sensitive CRP and fecal calprotectin were measured during the 8-week interval in 5 consecutive patients in clinical (Crohn's Disease Activity Index < 150) and endoscopic (Rutgeerts scores 0-1) remission after one year of therapy with infliximab 3 mg/Kg. For comparison with reported standards, infliximab pharmacokinetics and inflammatory parameters were also tested in 6 Crohn's disease patients who did not undergo surgery and who were in clinical remission while on infliximab 5 mg/Kg. Patients on low infliximab dose also underwent colonoscopy after 18 additional months of therapy.
Highly sensitive CRP and fecal calprotectin increased in all patients during the 8-week interval. Infliximab trough levels were lower in patients treated with the low dose compared to controls (mean±SE: 2.0±0.3 vs 4.75±0.83 μg/mL respectively p<0.05). Infliximab antibodies were present in two of the subjects treated with low infliximab dose and in none of the controls. However, in low dose-treated patients after 18 additional months of therapy endoscopy continued to show mucosal remission and none of them developed clinical recurrence or side effects.
Patients treated with low infliximab doses had lower trough levels compared to patients treated with 5 mg/Kg and some developed antibodies to infliximab. 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immunology</subject><subject>Infliximab - pharmacokinetics</subject><subject>Infliximab - therapeutic use</subject><subject>Leukocyte L1 Antigen Complex - metabolism</subject><subject>Male</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Mucosa</subject><subject>Patients</subject><subject>Pharmacokinetics</subject><subject>Pharmacology</subject><subject>Postoperative Period</subject><subject>Prevention</subject><subject>Prognosis</subject><subject>Recurrence</subject><subject>Recurrence (Disease)</subject><subject>Remission</subject><subject>Risk factors</subject><subject>Side effects</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Therapy</subject><subject>Tumor necrosis factor-TNF</subject><subject>Tumor necrosis factor-α</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99u0zAUxiMEYmPwBggsTeLPRYudOE7CBVK1MahUadPYuLUc57j15OYUO9nGK_GUOGs3tWgXOBeO7N_3neNjnyR5zeiYZQX7dIW9b5Ubr7CFMWWcV5Q-SfZZlaUjkdLs6db_XvIihCtK86wU4nmylwpR0LTg-8mfGd6QYwxApq1x9tYuVU0MenLm4RrazmJL0JAzDB2uwKvOXgM5B917D62GYe_I46J9H8ixDaACfCYzbOfkAvySnKBzeDO6XBHVNmS6XCndDZKtWBce-_mCzGI0F-6wSYxaY2MhkA630JfJM6NcgFeb-SC5PPl6cfR9NDv9Nj2azEZaVGk3qnKeqazOlDIFL2tTsbLIGshNUwqus9qIpqlFLkSpIBV1mac0SkBDRSHPOc8Okrdr35XDIDdlDpIVvGJFKaoyEtM10aC6kisfs_O_JSor7xbQz6XyndUOZEE1o42p60IZzpq0KoXmpqzSnMd7YXn0-rKJ1tdLaHSsuVdux3R3p7ULOcdryUVJqaDR4MPGwOOvHkInlzZocE61gP067zhoOuR9-A_6-Ok21FzFA9jWYIyrB1M54VmRFylnIlLjR6j4NbC0Or5JY-P6juDjjiAyHdx2c9WHIKc_zv-fPf25y77bYhegXLcI6Prh6YZdkK9B7TEED-ahyIzKoaXuqyGHlpKbloqyN9sX9CC676HsL3NQHPA</recordid><startdate>20151215</startdate><enddate>20151215</enddate><creator>Sorrentino, Dario</creator><creator>Marino, Marco</creator><creator>Dassopoulos, Themistocles</creator><creator>Zarifi, Dimitra</creator><creator>Del Bianco, Tiziana</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20151215</creationdate><title>Low Dose Infliximab for Prevention of Postoperative Recurrence of Crohn's Disease: Long Term Follow-Up and Impact of Infliximab Trough Levels and Antibodies to Infliximab</title><author>Sorrentino, Dario ; Marino, Marco ; Dassopoulos, Themistocles ; Zarifi, Dimitra ; Del Bianco, Tiziana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-9543a3b3aaf748bf91873de5fd864c3bf6ddb65668ae26b8520954ece90e55443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Analysis</topic><topic>Antibodies</topic><topic>Biomarkers - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sorrentino, Dario</au><au>Marino, Marco</au><au>Dassopoulos, Themistocles</au><au>Zarifi, Dimitra</au><au>Del Bianco, Tiziana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low Dose Infliximab for Prevention of Postoperative Recurrence of Crohn's Disease: Long Term Follow-Up and Impact of Infliximab Trough Levels and Antibodies to Infliximab</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-12-15</date><risdate>2015</risdate><volume>10</volume><issue>12</issue><spage>e0144900</spage><epage>e0144900</epage><pages>e0144900-e0144900</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>In patients with postoperative recurrence of Crohn's disease endoscopic and clinical remission can be maintained for up to 1 year with low infliximab doses (3 mg/Kg). However, in theory low-dose infliximab treated patients could develop subtherapeutic trough levels, infiximab antibodies, and might loose response to therapy. To verify this hypothesis infliximab pharmacokinetics and clinical/endoscopic response were checked in a group of patients treated in the long term with low infliximab doses.
Infliximab antibodies, infliximab levels, highly-sensitive CRP and fecal calprotectin were measured during the 8-week interval in 5 consecutive patients in clinical (Crohn's Disease Activity Index < 150) and endoscopic (Rutgeerts scores 0-1) remission after one year of therapy with infliximab 3 mg/Kg. For comparison with reported standards, infliximab pharmacokinetics and inflammatory parameters were also tested in 6 Crohn's disease patients who did not undergo surgery and who were in clinical remission while on infliximab 5 mg/Kg. Patients on low infliximab dose also underwent colonoscopy after 18 additional months of therapy.
Highly sensitive CRP and fecal calprotectin increased in all patients during the 8-week interval. Infliximab trough levels were lower in patients treated with the low dose compared to controls (mean±SE: 2.0±0.3 vs 4.75±0.83 μg/mL respectively p<0.05). Infliximab antibodies were present in two of the subjects treated with low infliximab dose and in none of the controls. However, in low dose-treated patients after 18 additional months of therapy endoscopy continued to show mucosal remission and none of them developed clinical recurrence or side effects.
Patients treated with low infliximab doses had lower trough levels compared to patients treated with 5 mg/Kg and some developed antibodies to infliximab. However, low infliximab doses sustained clinical and endoscopic remission for a total of 30 months of treatment.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26670274</pmid><doi>10.1371/journal.pone.0144900</doi><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_1749178698 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Analysis Antibodies Biomarkers - metabolism C-Reactive Protein - metabolism Care and treatment Case-Control Studies Colon Colonoscopy Complications and side effects Crohn Disease - drug therapy Crohn Disease - prevention & control Crohn Disease - surgery Crohn's disease Crohns disease Dosage and administration Dose-Response Relationship, Drug Drug dosages Drug therapy Endoscopy Enrollments Feces - chemistry Female Follow-Up Studies Gastroenterology Humans Immunoglobulins Immunotherapy Inflammation Inflammatory bowel disease Infliximab Infliximab - immunology Infliximab - pharmacokinetics Infliximab - therapeutic use Leukocyte L1 Antigen Complex - metabolism Male Medicine Middle Aged Monoclonal antibodies Mucosa Patients Pharmacokinetics Pharmacology Postoperative Period Prevention Prognosis Recurrence Recurrence (Disease) Remission Risk factors Side effects Surgery Systematic review Therapy Tumor necrosis factor-TNF Tumor necrosis factor-α |
| title | Low Dose Infliximab for Prevention of Postoperative Recurrence of Crohn's Disease: Long Term Follow-Up and Impact of Infliximab Trough Levels and Antibodies to Infliximab |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-13T03%3A14%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Low%20Dose%20Infliximab%20for%20Prevention%20of%20Postoperative%20Recurrence%20of%20Crohn's%20Disease:%20Long%20Term%20Follow-Up%20and%20Impact%20of%20Infliximab%20Trough%20Levels%20and%20Antibodies%20to%20Infliximab&rft.jtitle=PloS%20one&rft.au=Sorrentino,%20Dario&rft.date=2015-12-15&rft.volume=10&rft.issue=12&rft.spage=e0144900&rft.epage=e0144900&rft.pages=e0144900-e0144900&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0144900&rft_dat=%3Cgale_plos_%3EA437572416%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1749178698&rft_id=info:pmid/26670274&rft_galeid=A437572416&rft_doaj_id=oai_doaj_org_article_70c10dfbb7af41d2986c4f8925420315&rfr_iscdi=true |