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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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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. |
format | Online Article Text |
id | pubmed-8513849 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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