Serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel disease
Background Infliximab is an efficacious therapy for inflammatory bowel disease and may play a role in management of some extraintestinal manifestations. While higher trough levels of infliximab are associated with higher rates of disease remission, the association between trough levels of infliximab...
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BMJ Publishing Group
2021-10-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/8/1/e000788.full |
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| author | Daniel J Stein Andres J Yarur Shaina Sekhri Bharat Rao Akanksha Mohananey Poonam Beniwal-Patel Alexandra Bruss |
| author_facet | Daniel J Stein Andres J Yarur Shaina Sekhri Bharat Rao Akanksha Mohananey Poonam Beniwal-Patel Alexandra Bruss |
| author_sort | Daniel J Stein |
| collection | DOAJ |
| description | Background Infliximab is an efficacious therapy for inflammatory bowel disease and may play a role in management of some extraintestinal manifestations. While higher trough levels of infliximab are associated with higher rates of disease remission, the association between trough levels of infliximab and arthralgia activity characterised as an extraintestinal manifestation has yet to be defined.Objective We aimed to assess the association between serum trough levels of infliximab and peripheral arthralgia activity in patients with inflammatory bowel disease.Design In this cross-sectional study, we identified patients with inflammatory bowel disease on infliximab therapy with known history of arthralgias attributed to an extraintestinal manifestation. Collected variables included disease phenotype, medications (such as thiopurines or methotrexate), Harvey Bradshaw Index, partial Mayo score, C reactive protein, trough levels of infliximab and anti-infliximab antibodies. The primary outcome was active patient-reported arthralgia.Results Out of 267 patients included, 65 (24.4%) had active arthralgias at the time the trough level of infliximab was measured. No significant differences in trough levels were seen between those patients with and without arthralgias. Patients on combination therapy with methotrexate or thiopurines or those with detectable anti-infliximab antibodies were not more likely to have inactive arthralgias (OR 0.99, 95% CI 0.57 to 1.74, p=0.99 and OR 1.94, 95% CI 0.9 to 4.1, p=0.09, respectively).Conclusions This study suggests that although therapeutic drug monitoring of infliximab can have a role in the management of Crohn’s disease and ulcerative colitis, it does not seem to be useful in managing arthralgias associated with inflammatory bowel disease. |
| format | Article |
| id | doaj-art-abc336d113084fb2bcc5b2e38fe84c4c |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-abc336d113084fb2bcc5b2e38fe84c4c2024-12-07T08:50:12ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742021-10-018110.1136/bmjgast-2021-000788Serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel diseaseDaniel J Stein0Andres J Yarur1Shaina Sekhri2Bharat Rao3Akanksha Mohananey4Poonam Beniwal-Patel5Alexandra Bruss6Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USAGastroenterology & Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USADivision of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USADivision of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USADivision of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USADivision of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USADivision of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USABackground Infliximab is an efficacious therapy for inflammatory bowel disease and may play a role in management of some extraintestinal manifestations. While higher trough levels of infliximab are associated with higher rates of disease remission, the association between trough levels of infliximab and arthralgia activity characterised as an extraintestinal manifestation has yet to be defined.Objective We aimed to assess the association between serum trough levels of infliximab and peripheral arthralgia activity in patients with inflammatory bowel disease.Design In this cross-sectional study, we identified patients with inflammatory bowel disease on infliximab therapy with known history of arthralgias attributed to an extraintestinal manifestation. Collected variables included disease phenotype, medications (such as thiopurines or methotrexate), Harvey Bradshaw Index, partial Mayo score, C reactive protein, trough levels of infliximab and anti-infliximab antibodies. The primary outcome was active patient-reported arthralgia.Results Out of 267 patients included, 65 (24.4%) had active arthralgias at the time the trough level of infliximab was measured. No significant differences in trough levels were seen between those patients with and without arthralgias. Patients on combination therapy with methotrexate or thiopurines or those with detectable anti-infliximab antibodies were not more likely to have inactive arthralgias (OR 0.99, 95% CI 0.57 to 1.74, p=0.99 and OR 1.94, 95% CI 0.9 to 4.1, p=0.09, respectively).Conclusions This study suggests that although therapeutic drug monitoring of infliximab can have a role in the management of Crohn’s disease and ulcerative colitis, it does not seem to be useful in managing arthralgias associated with inflammatory bowel disease.https://bmjopengastro.bmj.com/content/8/1/e000788.full |
| spellingShingle | Daniel J Stein Andres J Yarur Shaina Sekhri Bharat Rao Akanksha Mohananey Poonam Beniwal-Patel Alexandra Bruss Serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel disease BMJ Open Gastroenterology |
| title | Serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel disease |
| title_full | Serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel disease |
| title_fullStr | Serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel disease |
| title_full_unstemmed | Serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel disease |
| title_short | Serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel disease |
| title_sort | serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel disease |
| url | https://bmjopengastro.bmj.com/content/8/1/e000788.full |
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