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Teresa J, Chamaida PR, Ana MF, et al. Predictive Value of Serum Infliximab Levels at Induction Phase in Rheumatoid Arthritis Patients. Open Rheumatol J. 2017;11:75-87doi: 10.2174/1874312901711010075.
Teresa, J., Chamaida, P. R., Ana, M. F., Victoria, N. C., Theo, R., Annick, V., Karien, B., Eva-María, O., Cristina, D., Alejandro, V., Diana, P., Laura, N., Maria-Gema, B., Alejandro, B., & Dora, P. S. (2017). Predictive Value of Serum Infliximab Levels at Induction Phase in Rheumatoid Arthritis Patients. The open rheumatology journal, 1175-87. https://doi.org/10.2174/1874312901711010075
Teresa, Jurado, et al. "Predictive Value of Serum Infliximab Levels at Induction Phase in Rheumatoid Arthritis Patients." The open rheumatology journal vol. 11 (2017): 75-87. doi: https://doi.org/10.2174/1874312901711010075
Teresa J, Chamaida PR, Ana MF, Victoria NC, Theo R, Annick V, Karien B, Eva-María O, Cristina D, Alejandro V, Diana P, Laura N, Maria-Gema B, Alejandro B, Dora PS. Predictive Value of Serum Infliximab Levels at Induction Phase in Rheumatoid Arthritis Patients. Open Rheumatol J. 2017 Jun 29;11:75-87. doi: 10.2174/1874312901711010075. eCollection 2017. PMID: 28761564; PMCID: PMC5510569.
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Open Rheumatol J. 2017 Jun 29;11:75-87. doi: 10.2174/1874312901711010075. eCollection 2017.

Predictive Value of Serum Infliximab Levels at Induction Phase in Rheumatoid Arthritis Patients.

The open rheumatology journal

Jurado Teresa, Plasencia-Rodríguez Chamaida, Martínez-Feito Ana, Navarro-Compán Victoria, Rispens Theo, Vries Annick, Bloem Karien, Olariaga Eva-María, Diego Cristina, Villalba Alejandro, Peiteado Diana, Nuño Laura, Bonilla Maria-Gema, Balsa Alejandro, Pascual-Salcedo Dora

Affiliations

  1. Immunology Unit, University Hospital La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain.
  2. Rheumatology Department and Institute for Health Research (IdiPAZ), University Hospital La Paz, Madrid, Spain.
  3. Sanquin Research; Department Immunophatology; Amsterdam, The Netherland; and Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam, The Netherlands.

PMID: 28761564 PMCID: PMC5510569 DOI: 10.2174/1874312901711010075

Abstract

BACKGROUND: The Infliximab, has proven effective in treating rheumatoid arthritis (RA). A good clinical response is usually associated with high serum drug levels. Development of antibodies toward Infliximab (ATI) can increase drug clearance, leading to treatment failure.

AIMS: To analyze whether serum Infliximab trough levels (ITL) at the induction phase are associated with Infliximab clearance and clinical outcomes at week(W) 54 and to investigate the association with immunogenicity development.

METHODS: Observational retrospective study in which ITL from 66 RA patients were measured by capture ELISA at W0, W2, W6, W14 and 22. Patients were classified as ITLpos if Infliximab was detectable at W54 and ITLneg otherwise. ATI were assayed by bridging ELISA and by two drug-tolerant assays. ITL cut-off values were established by ROC curves. The association between ITL at early-stage and clearance of Infliximab at W54 was analyzed by univariable and multivariable logistic regression.

RESULTS: ITLneg patients (n=25) always had significantly lower Infliximab levels than ITLpos (n=41). An ITL value of 4.4 μg/mL at W6 best predicted W54 Infliximab absence. In the multivariable analysis, only ITL below the cut-off at W6 (OR: 86.6; 95%CI: 6.58-1139.99) and non-use of methotrexate (OR: 6.9; 95%CI: 1.04-45.84) remained significantly associated with W54 Infliximab absence. ATI were more frequent in patients with ITL below the cut-off at W6.

CONCLUSIONS: In RA, ITL at induction phase are inversely associated with Infliximab clearance and clinical outcomes at W54. ATI was the main reason for low early ITL. A predictive value of ITL at W6 was found as a useful prognostic measure of treatment efficacy.

Keywords: Early immunogenicity; Induction phase; Infliximab therapy; Levels clearance; Loss of efficacy; Rheumatoid Arthritis

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