Pharmacokinetics of Infliximab and Reduction of Treatment for Inflammatory Bowel Diseases.
Fiche publication
Date publication
avril 2016
Journal
Digestive diseases and sciences
Auteurs
Membres identifiés du Cancéropôle Est :
Pr PEYRIN-BIROULET Laurent
Tous les auteurs :
Williet N, Paul S, Peyrin-Biroulet L, Roblin X
Lien Pubmed
Résumé
Local or national policy, patients' preferences, safety and/or economic concerns, or reimbursement issues may dictate stopping drug in inflammatory bowel diseases (IBD) patients. Sustained deep remission is an important predictor of a better outcome after anti-tumor necrosis (TNF) factor therapy discontinuation, including infliximab (IFX) in IBD patients, but this is not sufficient to prevent future relapse in these patients. In IBD patients under combotherapy, trough level of infliximab (TRI) could be helpful to choose stopping one of the two drugs. In patients on IFX monotherapy, TRI could help to decide reduction of drug dosing, particularly in IBD patients with supratherapeutic trough levels. Incidental findings of undetectable TRI in patients with deep remission may identify a subset of patients who may be considered for IFX cessation. Controlled trials further assessing this issue are eagerly awaited. Pending these trials, clear international recommendations for discontinuing anti-TNF therapy are needed.
Mots clés
De-escalation, Inflammatory bowel disease, Infliximab, Pharmacokinetics, Reduction, Trough level of infliximab
Référence
Dig. Dis. Sci.. 2016 Apr;61(4):990-5