John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Interest of trough serum levels for predicting the response to infliximab in IBD patients Volume 18, supplement 5, Septembre 2011

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Authors
CHU de Saint-Étienne, Service de gastroentérologie, 42 000 Saint-Étienne, France, CHU de Saint-Étienne, laboratoire d’immunologie, 42 000 Saint-Étienne, France

The contribution of anti-TNF monoclonal antibodies has considerably changed our care in the inflammatory bowel disease (IBD) therapeutic. The loss of effectiveness of these molecules with the time is well established and the optimization of these treatments is recommended. The contribution of the immunoassays allowing infliximab and infliximab-specific antibodies (ATI/human anti-chimeric antibodies [HACA]) determination is important in the case of therapeutic exhaust. These concomitant determinations thus allow customizing our requirements. Thus, in cases of therapeutic failure under infliximab treatment and in the absence of residual rate, we will discuss an increase of doses while a measurable rate will discuss a change of therapeutic class. One of the current pitfall is the absence of predictive “cut-off” of therapeutic response concerning the level of infliximab in the serum linked to a high interindividual variability of patients with this type of determination. There are, in any case, strong correlations between therapeutic response and serum infliximab trough levels. In the future, it will be important to know if the optimization must be proposed in case of significant decline in serum infliximab trough level before any clinical relapse.