Effect of Proactive and Reactive Therapeutic Drug Monitoring of Infliximab on Prognosis of Patients With Inflammatory Bowel Disease
10.3969/j.issn.1008-7125.2023.10.002
- VernacularTitle:英夫利西单抗主动和被动治疗药物监测对炎症性肠病患者预后的影响
- Author:
Huan LIU
1
;
Ning LÜ
;
Kaichun WU
;
Yongquan SHI
;
Min CHEN
Author Information
1. 空军军医大学第一附属医院消化内科(710032)
- Keywords:
Crohn Disease;
Colitis,Ulcerative;
Infliximab;
Therapeutic Drug Monitoring
- From:
Chinese Journal of Gastroenterology
2023;28(10):584-589
- CountryChina
- Language:Chinese
-
Abstract:
Background:Therapeutic drug monitoring(TDM)has emerged as the important method for managing loss of response to infliximab.The effect of reactive and proactive TDM on clinical outcomes in inflammatory bowel disease(IBD)is uncertain.Aims:To evaluate the effect of proactive and reactive TDM of infliximab on the prognosis of patients with IBD.Methods:Clinical data of 99 IBD patients treated with IFX from January 2017 to October 2021 at the First Affiliated Hospital of Air Force Military Medical University were retrospectively analyzed,including 34 patients with proactive TDM and 65 patients with reactive TDM.The rate of treatment failure,IBD-related surgery or hospitalization were compared between the two groups.Logistic regression analysis was used to determine the independent risk factors of treatment failure.Results:The median follow-up of the patients was 21(13,32)months.The rate of treatment failure,IBD-related hospitalization rate of proactive TDM group were significantly lower than those of reactive TDM group(P<0.05),however,no significant difference in IBD-related surgery rate was found between two groups(P=0.081).Univariate analysis showed that ileocolonic resection before TDM,antibodies to infliximab(ATI)and reactive TDM might be correlated with treatment failure(P<0.05).Logistic regression analysis showed that reactive TDM(OR=5.829,95%CI:1.070-31.754,P=0.042)was the risk factor of treatment failure,and ileocolonic resection before TDM(OR=0.119,95%CI:0.019-0.736,P=0.022)was the protective factor of treatment failure.Conclusions:Compared with reactive TDM group,proactive TDM can significantly decrease the rate of treatment failure and IBD-related hospitalization rate.Reactive TDM is the risk factor of treatment failure,and ileocolonic resection before TDM is the protective factor of treatment failure.
