Oh Eun Hye, Ko Dae-Hyun, Seo Hyungil, Chang Kiju, Kim Gwang-Un, Song Eun Mi, Seo Myeongsook, Lee Ho-Su, Hwang Sung Wook, Yang Dong-Hoon, Ye Byong Duk, Byeon Jeong-Sik, Myung Seung-Jae, Yang Suk-Kyun, Park Sang Hyoung
Eun Hye Oh, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea.
World J Gastroenterol. 2017 Feb 28;23(8):1489-1496. doi: 10.3748/wjg.v23.i8.1489.
To investigate the clinical implications of infliximab trough levels (IFX-TLs) and antibodies to infliximab (ATI) levels in Crohn's disease (CD) patients in Asian countries.
IFX-TL and ATI level were measured using prospectively collected samples obtained with informed consent from CD patients being treated at Asan Medical Center, South Korea. We analyzed the correlations between IFX-TLs/ATI levels and the clinical activity of CD (quiescent active disease) based on the CD activity index, C-reactive protein level, and physician's judgment of patients' clinical status at enrollment. The impact of concomitant immunomodulators was also investigated.
This study enrolled 138 patients with CD (84 with quiescent and 54 with active disease). In patients with quiescent and active diseases, the median IFX-TLs were 1.423 μg/mL and 0.163 μg/mL, respectively ( < 0.001) and the median ATI levels were 8.064 AU/mL and 11.209 AU/mL, respectively ( < 0.001). In the ATI-negative and -positive groups, the median IFX-TLs were 1.415 μg/mL and 0.141 μg/mL, respectively ( < 0.001). In patients with and without concomitant immunomodulator use, there were no differences in IFX-TLs (0.632 μg/mL and 1.150 μg/mL, respectively; = 0.274) or ATI levels (8.655 AU/mL and 9.017 AU/mL, respectively; = 0.083).
IFX-TL/ATI levels were well correlated with the clinical activity in South Korean CD patients. Our findings support the usefulness of IFX-TLs/ATI levels in treating CD patients receiving IFX in clinical practice.
探讨亚洲国家克罗恩病（CD）患者英夫利昔单抗谷浓度（IFX-TLs）及抗英夫利昔单抗抗体（ATI）水平的临床意义。
使用前瞻性收集的样本，这些样本来自韩国峨山医院正在接受治疗且已签署知情同意书的CD患者，以此来检测IFX-TL和ATI水平。我们基于CD活动指数、C反应蛋白水平以及入组时医生对患者临床状态的判断，分析了IFX-TLs/ATI水平与CD临床活动（静止期/活动期疾病）之间的相关性。同时也研究了联合使用免疫调节剂的影响。
本研究纳入了138例CD患者（84例处于静止期，54例处于活动期）。在静止期和活动期患者中，IFX-TLs的中位数分别为1.423μg/mL和0.163μg/mL（<0.001），ATI水平的中位数分别为8.064AU/mL和11.209AU/mL（<0.001）。在ATI阴性和阳性组中，IFX-TLs的中位数分别为1.415μg/mL和0.141μg/mL（<0.001）。在联合使用免疫调节剂和未使用免疫调节剂的患者中，IFX-TLs（分别为0.632μg/mL和1.150μg/mL；P=0.274）或ATI水平（分别为8.655AU/mL和9.017AU/mL；P=0.083）没有差异。
IFX-TL/ATI水平与韩国CD患者的临床活动密切相关。我们的研究结果支持在临床实践中，IFX-TLs/ATI水平对接受IFX治疗的CD患者的治疗具有指导作用。
