Proactive Infliximab Monitoring Improves the Rates of Transmural Remission in Crohn's Disease: A Propensity Score-Matched Analysis.

IF 4.5 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Inflammatory Bowel Diseases Pub Date : 2024-11-04 DOI:10.1093/ibd/izad272

Samuel Raimundo Fernandes, Sónia Bernardo, Sofia Saraiva, Ana Rita Gonçalves, Paula Moura Santos, Ana Valente, Luís Araújo Correia, Helena Cortez-Pinto, Fernando Magro

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Abstract

Background: Few patients can reach transmural remission in Crohn's disease (CD) with currently available therapies. Proactive optimization of infliximab (IFX) based on trough levels may potentially improve these results.

Methods: Retrospective cohort study including consecutive CD patients starting treatment with IFX. Rates of transmural remission were compared between patients with and without therapeutic drug monitoring (target level: 5-7 µg/mL). A propensity score-matched analysis was performed to adjust for potential confounders.

Results: A total of 195 CD patients were included, 57.9% receiving proactive therapeutic drug monitoring. The rates of transmural remission were higher in patients under proactive therapeutic drug monitoring (37.2% vs 18.3%; P = .004) with similar results in the propensity score-matched analysis (34.2% vs 17.1%; P = .025). In multivariate analysis, proactive therapeutic drug monitoring was independently associated with transmural remission (odds ratio, 2.95; 95% confidence interval, 1.44-6.06; P = .003).

Conclusions: Proactive optimization of IFX based on trough levels increases the rates of transmural remission in CD.

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主动监测英夫利昔单抗可提高克罗恩病经壁缓解率:倾向评分匹配分析

背景:在目前可用的治疗方法下，很少有克罗恩病(CD)患者能达到跨壁缓解。基于低谷水平的主动优化英夫利昔单抗(IFX)可能潜在地改善这些结果。方法:回顾性队列研究，包括连续开始使用IFX治疗的CD患者。比较有和没有治疗药物监测的患者的跨壁缓解率(目标水平:5-7µg/mL)。进行倾向评分匹配分析以调整潜在混杂因素。结果:共纳入195例CD患者，57.9%的患者接受了积极的治疗药物监测。接受积极治疗药物监测的患者经壁缓解率更高(37.2% vs 18.3%;P = 0.004)，倾向评分匹配分析结果相似(34.2% vs 17.1%;p = .025)。在多变量分析中，积极的治疗药物监测与跨壁缓解独立相关(优势比，2.95;95%置信区间为1.44-6.06;p = .003)。结论:基于谷底水平的IFX的主动优化增加了CD的跨壁缓解率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammatory Bowel Diseases 医学-胃肠肝病学

CiteScore

9.70

自引率

6.10%

发文量

462

审稿时长

1 months

期刊介绍： Inflammatory Bowel Diseases® supports the mission of the Crohn''s & Colitis Foundation by bringing the most impactful and cutting edge clinical topics and research findings related to inflammatory bowel diseases to clinicians and researchers working in IBD and related fields. The Journal is committed to publishing on innovative topics that influence the future of clinical care, treatment, and research.