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CC BY-NC-ND 4.0 · Journal of Coloproctology 2023; 43(04): e276-e279
DOI: 10.1055/s-0043-1776892
Original Article

Therapeutic Drug Monitoring in Inflammatory Bowel Disease

Manoel Alvaro de Freitas Lins Neto 
1   Federal University of Alagoas, Universidade Federal de Alagoas Faculdade de Medicina, UFAL| UFAL FAMED, Maceió, Alagoas, Brazil
,
João Otávio Moraes Rolim
1   Federal University of Alagoas, Universidade Federal de Alagoas Faculdade de Medicina, UFAL| UFAL FAMED, Maceió, Alagoas, Brazil
,
Diogo César Maurício de Oliveira Jatobá
2   Universidade Federal de Alagoas Faculdade de Medicina, UFAL FAMED, Maceió, Alagoas, Brazil
,
Júnia Elisa Carvalho de Meira
1   Federal University of Alagoas, Universidade Federal de Alagoas Faculdade de Medicina, UFAL| UFAL FAMED, Maceió, Alagoas, Brazil
,
Luís Henrique Salvador Filho
1   Federal University of Alagoas, Universidade Federal de Alagoas Faculdade de Medicina, UFAL| UFAL FAMED, Maceió, Alagoas, Brazil
,
Lucas Correia Lins
1   Federal University of Alagoas, Universidade Federal de Alagoas Faculdade de Medicina, UFAL| UFAL FAMED, Maceió, Alagoas, Brazil
,
Jorge Artur Coelho Peçanha
1   Federal University of Alagoas, Universidade Federal de Alagoas Faculdade de Medicina, UFAL| UFAL FAMED, Maceió, Alagoas, Brazil
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Abstract

Inflammatory bowel disease (IBD) is a problem that directly affects the quality of life of patients suffering from this condition. Monitoring the serum level of infliximab (IFX) (TDM) is an important tool for guiding therapeutic decisions in IBD patients. The purpose of this study was to determine the significance of quantitatively measuring the serum level of IFX (TDM) and antibody to IFX (ATI). Methods and materials: Prospective observational study involving 40 IBD patients on IFX therapy, including 14 Proactive (week 06 of the induction phase) and 26 Reactive (maintenance phase). Immediately prior to the infusion, blood samples were drawn and measured using a Bulhlmann rapid test instrument. Serum concentrations of IFX were categorized as supratherapeutic (>7.0 micrograms/ml), therapeutic (between 3.0 and 7.0 micrograms/ml), and subtherapeutic (3.0 micrograms/ml). When the serum concentration of IFX was 3 mcg/ml (subtherapeutic), the ATI was measured. 25 patients with CD and 15 patients with UC were evaluated. Only three of the twenty patients with subtherapeutic serum levels had a positive ATI, and both were reactive; two had CD and one had UC. There was a statistically significant difference between reactive and proactive patients with respect to levels of CRP (p = 0.042), with proactive DNS patients suffering greater alterations in CRP and albumin.

Keywords

infliximab antibody - infliximab - drug monitoring - therapeutic drug


Publication History

Received: 07 August 2023

Accepted: 24 October 2023

Article published online:
27 November 2023

© 2023. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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