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Infliximab concentrations during induction are predictive for endoscopic remission in pediatric patients with inflammatory bowel disease under combination therapy

The Journal of Pediatrics Sep 09, 2021

van Hoeve K, Tabib NSS, Dreesen E, et al. - In children with inflammatory bowel disease (IBD), higher infliximab (IFX) exposure during induction therapy is linked to significantly superior endoscopic and deep remission rates at six months. From Week 4 post-induction onwards, drug concentrations distinguish remitters from non-remitters.

  • From May 2017 to May 2019, all children with IBD who started IFX medication (5 mg/kg at weeks 0-2-6 and 12) for active luminal disease were included and followed prospectively.

  • Thirty-two patients provided 252 serum induction concentrations (81% on concomitant thiopurines).

  • From week 4 onwards, children in endoscopic remission (all in deep remission) showed significantly greater drug concentrations.

  • ROC curve analysis determined that IFX TC at week 12 ≥ 5.0 μg/mL and AUC week 0-12 ≥ 4056.0 μg*day/mL were the minimal targets for achieving endoscopic remission at six months (AUROC: 0.796 [95%CI: 0.62-0.97] and AUROC: 0.778 [95%CI: 0.61-0.94], respectively).

  • Furthermore, the findings suggest that proteomic analysis may aid in understanding IFX response.

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