Therapeutic drug monitoring of infliximab: performance evaluation of three commercial ELISA kits

Therapeutic drug monitoring (TDM) of infliximab (IFX, Remicade ) can aid to optimize therapy efficacy. Many assays are available for this purpose. However, a reference standard is lacking. Therefore, we evaluated the analytical performance, agreement and clinically relevant differences of three comm...

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Veröffentlicht in:Clinical chemistry and laboratory medicine 2016-07, Vol.54 (7), p.1211-1219
Hauptverfasser: Schmitz, Ellen M.H., van de Kerkhof, Daan, Hamann, Dörte, van Dongen, Joost L.J., Kuijper, Philip H.M., Brunsveld, Luc, Scharnhorst, Volkher, Broeren, Maarten A.C.
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container_end_page 1219
container_issue 7
container_start_page 1211
container_title Clinical chemistry and laboratory medicine
container_volume 54
creator Schmitz, Ellen M.H.
van de Kerkhof, Daan
Hamann, Dörte
van Dongen, Joost L.J.
Kuijper, Philip H.M.
Brunsveld, Luc
Scharnhorst, Volkher
Broeren, Maarten A.C.
description Therapeutic drug monitoring (TDM) of infliximab (IFX, Remicade ) can aid to optimize therapy efficacy. Many assays are available for this purpose. However, a reference standard is lacking. Therefore, we evaluated the analytical performance, agreement and clinically relevant differences of three commercially available IFX ELISA kits on an automated processing system. The kits of Theradiag (Lisa Tracker Infliximab), Progenika (Promonitor IFX) and apDia (Infliximab ELISA) were implemented on an automated processing system. Imprecision was determined by triplicate measurements of patient samples on five days. Agreement was evaluated by analysis of 30 patient samples and four spiked samples by the selected ELISA kits and the in-house IFX ELISA of Sanquin Diagnostics (Amsterdam, The Netherlands). Therapeutic consequences were evaluated by dividing patients into four treatment groups using cut-off levels of 1, 3 and 7 μg/mL and determining assay concordance. Within-run and between-run imprecision were acceptable (≤12% and ≤17%, respectively) within the quantification range of the selected ELISA kits. The apDia assay had the best precision and agreement to target values. Statistically significant differences were found between all assays except between Sanquin Diagnostics and the Lisa Tracker assay. The Promonitor assay measured the lowest IFX concentrations, the apDia assay the highest. When patients were classified in four treatment categories, 70% concordance was achieved. Although all assays are suitable for TDM, significant differences were observed in both imprecision and agreement. Therapeutic consequences were acceptable when patients were divided in treatment categories, but this could be improved by assay standardization.
doi_str_mv 10.1515/cclm-2015-0987
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source MEDLINE; De Gruyter journals
subjects assay comparison
Drug Monitoring - methods
ELISA
Enzyme-Linked Immunosorbent Assay - methods
Gastrointestinal Agents - blood
Humans
Infliximab
Infliximab - blood
Netherlands
Predictive Value of Tests
Reagent Kits, Diagnostic
therapeutic drug monitoring
title Therapeutic drug monitoring of infliximab: performance evaluation of three commercial ELISA kits
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