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Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data

Infliximab (IFX) therapy has considerably improved the treatment of rheumatoid arthritis (RA). However, some patients still do not respond adequately to IFX therapy, or the efficacy of the treatment diminishes over time. Although previous studies have reported a relationship between serum IFX levels...

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Autores principales: Nakae, Kazuto, Masui, Sho, Yonezawa, Atsushi, Hashimoto, Motomu, Watanabe, Ryu, Murata, Koichi, Murakami, Kosaku, Tanaka, Masao, Ito, Hiromu, Yokoyama, Kotoko, Iwamoto, Noriko, Shimada, Takashi, Nakamura, Miyuki, Denda, Masaya, Itohara, Kotaro, Nakagawa, Shunsaku, Ikemi, Yasuaki, Imai, Satoshi, Nakagawa, Takayuki, Hayakari, Makoto, Matsubara, Kazuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8513849/
https://www.ncbi.nlm.nih.gov/pubmed/34644354
http://dx.doi.org/10.1371/journal.pone.0258601
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author Nakae, Kazuto
Masui, Sho
Yonezawa, Atsushi
Hashimoto, Motomu
Watanabe, Ryu
Murata, Koichi
Murakami, Kosaku
Tanaka, Masao
Ito, Hiromu
Yokoyama, Kotoko
Iwamoto, Noriko
Shimada, Takashi
Nakamura, Miyuki
Denda, Masaya
Itohara, Kotaro
Nakagawa, Shunsaku
Ikemi, Yasuaki
Imai, Satoshi
Nakagawa, Takayuki
Hayakari, Makoto
Matsubara, Kazuo
author_facet Nakae, Kazuto
Masui, Sho
Yonezawa, Atsushi
Hashimoto, Motomu
Watanabe, Ryu
Murata, Koichi
Murakami, Kosaku
Tanaka, Masao
Ito, Hiromu
Yokoyama, Kotoko
Iwamoto, Noriko
Shimada, Takashi
Nakamura, Miyuki
Denda, Masaya
Itohara, Kotaro
Nakagawa, Shunsaku
Ikemi, Yasuaki
Imai, Satoshi
Nakagawa, Takayuki
Hayakari, Makoto
Matsubara, Kazuo
author_sort Nakae, Kazuto
collection PubMed
description Infliximab (IFX) therapy has considerably improved the treatment of rheumatoid arthritis (RA). However, some patients still do not respond adequately to IFX therapy, or the efficacy of the treatment diminishes over time. Although previous studies have reported a relationship between serum IFX levels and therapeutic efficacy, the potential applications of IFX therapeutic drug monitoring (TDM) in clinical practice remain unclear. The purpose of this study was to investigate the potential applications of IFX TDM by analyzing a Japanese cohort database. Data were collected retrospectively from the Kyoto University Rheumatoid Arthritis Management Alliance cohort between January 1, 2011, and December 31, 2018. Serum IFX levels were measured using a liquid chromatography-tandem mass spectrometer. Out of the 311 RA patients that used IFX, 41 were eligible for the analysis. Serum IFX levels were significantly higher in responders than in non-responders. An optimal cut-off value was determined to be 0.32 μg/mL based on a receiver operating characteristic curve. At the IFX measurement point, a better therapeutic response was observed in the high IFX group (n = 32) than in the low IFX group (n = 9). Conversely, at the maximum effect point, when DAS28-ESR was the lowest between IFX introduction and measurement points, there were no differences in responder proportions between the low and high IFX groups. IFX primary ineffectiveness could be avoided with appropriate dose escalation without blood concentration measurement in clinical practice. In conclusion, IFX TDM could facilitate the identification of secondary non-responders and in turn, proper IFX use.
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spelling pubmed-85138492021-10-14 Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data Nakae, Kazuto Masui, Sho Yonezawa, Atsushi Hashimoto, Motomu Watanabe, Ryu Murata, Koichi Murakami, Kosaku Tanaka, Masao Ito, Hiromu Yokoyama, Kotoko Iwamoto, Noriko Shimada, Takashi Nakamura, Miyuki Denda, Masaya Itohara, Kotaro Nakagawa, Shunsaku Ikemi, Yasuaki Imai, Satoshi Nakagawa, Takayuki Hayakari, Makoto Matsubara, Kazuo PLoS One Research Article Infliximab (IFX) therapy has considerably improved the treatment of rheumatoid arthritis (RA). However, some patients still do not respond adequately to IFX therapy, or the efficacy of the treatment diminishes over time. Although previous studies have reported a relationship between serum IFX levels and therapeutic efficacy, the potential applications of IFX therapeutic drug monitoring (TDM) in clinical practice remain unclear. The purpose of this study was to investigate the potential applications of IFX TDM by analyzing a Japanese cohort database. Data were collected retrospectively from the Kyoto University Rheumatoid Arthritis Management Alliance cohort between January 1, 2011, and December 31, 2018. Serum IFX levels were measured using a liquid chromatography-tandem mass spectrometer. Out of the 311 RA patients that used IFX, 41 were eligible for the analysis. Serum IFX levels were significantly higher in responders than in non-responders. An optimal cut-off value was determined to be 0.32 μg/mL based on a receiver operating characteristic curve. At the IFX measurement point, a better therapeutic response was observed in the high IFX group (n = 32) than in the low IFX group (n = 9). Conversely, at the maximum effect point, when DAS28-ESR was the lowest between IFX introduction and measurement points, there were no differences in responder proportions between the low and high IFX groups. IFX primary ineffectiveness could be avoided with appropriate dose escalation without blood concentration measurement in clinical practice. In conclusion, IFX TDM could facilitate the identification of secondary non-responders and in turn, proper IFX use. Public Library of Science 2021-10-13 /pmc/articles/PMC8513849/ /pubmed/34644354 http://dx.doi.org/10.1371/journal.pone.0258601 Text en © 2021 Nakae et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Nakae, Kazuto
Masui, Sho
Yonezawa, Atsushi
Hashimoto, Motomu
Watanabe, Ryu
Murata, Koichi
Murakami, Kosaku
Tanaka, Masao
Ito, Hiromu
Yokoyama, Kotoko
Iwamoto, Noriko
Shimada, Takashi
Nakamura, Miyuki
Denda, Masaya
Itohara, Kotaro
Nakagawa, Shunsaku
Ikemi, Yasuaki
Imai, Satoshi
Nakagawa, Takayuki
Hayakari, Makoto
Matsubara, Kazuo
Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data
title Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data
title_full Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data
title_fullStr Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data
title_full_unstemmed Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data
title_short Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data
title_sort potential application of measuring serum infliximab levels in rheumatoid arthritis management: a retrospective study based on kurama cohort data
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8513849/
https://www.ncbi.nlm.nih.gov/pubmed/34644354
http://dx.doi.org/10.1371/journal.pone.0258601
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