PMID- 37991266
OWN - NLM
STAT- MEDLINE
DCOM- 20240228
LR  - 20240320
IS  - 1502-7708 (Electronic)
IS  - 0036-5521 (Linking)
VI  - 59
IP  - 3
DP  - 2024 Mar
TI  - The impact of proactive versus reactive drug monitoring of infliximab on 
      treatment outcomes in patients with crohn's disease.
PG  - 269-279
LID - 10.1080/00365521.2023.2283387 [doi]
AB  - BACKGROUND: Therapeutic drug monitoring (TDM) plays a crucial role in the 
      management of Crohn's disease (CD) patients receiving infliximab (IFX). While 
      reactive TDM has been more commonly utilized previously, recent research suggests 
      that proactive TDM may offer greater benefits for patients. OBJECTIVE: To compare 
      treatment outcomes among patients receiving different monitoring modalities of 
      IFX. METHODS: This was a retrospective cohort study that enrolled 142 CD patients 
      who initiated IFX therapy at the First Affiliated Hospital of Nanjing Medical 
      University from January 2014 to June 2021. The patients were divided into a 
      reactive (n = 43) and proactive (n = 99) group. The outcome measures included 
      sustained clinical response and remission rates, biological remission rates, 
      endoscopic response and remission rates achieved in both groups at weeks 30 and 
      54. The incidence of adverse events (AEs), changes in IFX trough concentrations 
      (TCs) and treatment adjustments within 54 weeks were also evaluated. RESULTS: 
      Kaplan-Meier analysis demonstrated that the proactive group exhibited 
      significantly higher cumulative probabilities of sustained clinical response, 
      sustained clinical remission, and endoscopic response by Week 54. Compared to the 
      reactive group, patients in the proactive group achieved significantly reduced 
      rates of AEs-related hospitalization and surgery. After adjusting treatment 
      strategies, the median concentration and the proportion of patients achieved an 
      effective therapeutic concentration (TC > 3 mug/mL) at Week 54 was both 
      significantly higher in the proactive group. CONCLUSIONS: Proactive TDM of IFX 
      plays a more crucial role in timely adjustment of treatment strategies and 
      maintenance of effective concentrations, thereby contributing to the outcomes for 
      CD patients.
FAU - Zhang, Yue
AU  - Zhang Y
AUID- ORCID: 0000-0001-5293-4540
AD  - Department of Gastroenterology, Northern Jiangsu People's Hospital Affiliated to 
      Yangzhou University, Yangzhou, China.
FAU - Jiang, Wenyu
AU  - Jiang W
AD  - Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Xu, Chenjing
AU  - Xu C
AD  - Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Tian, Jiahui
AU  - Tian J
AD  - Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Chen, Jie
AU  - Chen J
AD  - Department of Gastroenterology, Northern Jiangsu People's Hospital Affiliated to 
      Yangzhou University, Yangzhou, China.
FAU - Zhang, Hongjie
AU  - Zhang H
AUID- ORCID: 0000-0003-4497-0503
AD  - Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
LA  - eng
PT  - Journal Article
DEP - 20231122
PL  - England
TA  - Scand J Gastroenterol
JT  - Scandinavian journal of gastroenterology
JID - 0060105
RN  - 0 (Gastrointestinal Agents)
RN  - B72HH48FLU (Infliximab)
SB  - IM
MH  - Humans
MH  - *Crohn Disease/drug therapy
MH  - *Drug Monitoring
MH  - *Gastrointestinal Agents/adverse effects
MH  - *Infliximab/therapeutic use
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Crohn disease
OT  - anti-drug antibody
OT  - infliximab
OT  - therapeutic drug monitoring
EDAT- 2023/11/22 12:44
MHDA- 2024/02/28 06:45
CRDT- 2023/11/22 08:13
PHST- 2024/02/28 06:45 [medline]
PHST- 2023/11/22 12:44 [pubmed]
PHST- 2023/11/22 08:13 [entrez]
AID - 10.1080/00365521.2023.2283387 [doi]
PST - ppublish
SO  - Scand J Gastroenterol. 2024 Mar;59(3):269-279. doi: 
      10.1080/00365521.2023.2283387. Epub 2023 Nov 22.