Pękala Anna, Filip Rafał
Department of Gastroenterology with IBD, Unit of Clinical Hospital 2 in Rzeszow, Lwowska 60, 35-301 Rzeszow, Poland.
Faculty of Medicine, University of Rzeszow, Aleja Majora Wacława Kopisto 2a, 35-210 Rzeszow, Poland.
J Clin Med. 2021 Nov 15;10(22):5311. doi: 10.3390/jcm10225311.
Primary lack or secondary loss of response to therapy with infliximab is a significant problem. This study aimed to evaluate the response to treatment in patients with Crohn's disease (CD) and ulcerative colitis (UC) achieving therapeutic and sub-therapeutic trough levels of biosimilar infliximab (CT-P13).
A total of 65 patients (32 with CD and 33 with UC) were recruited. The overall response rate in both CD and UC patients exceeded 80%. There were no significant differences in treatment response and CT-P13 levels for patients with CD or UC. We did not find significant differences in the percentage of patients achieving drug levels of 3 μg/mL at week 6, 10, or 12; a significant decrease was observed at week 14. Up to 55.5% of patients with CD and 64.3% of patients with UC with sub-therapeutic CT-P13 levels at week 14 primarily responded to treatment.
Intermediate measurements of drug levels at weeks 10 and 12 did not capture any pronounced decrease in infliximab concentrations below therapeutic levels in either group, thus suggesting no clinical usefulness. A significant percentage of patients primarily responded to treatment despite sub-therapeutic drug levels after the induction phase.
对英夫利昔单抗治疗原发性缺乏反应或继发性反应丧失是一个重大问题。本研究旨在评估达到生物类似药英夫利昔单抗(CT-P13)治疗性和亚治疗性谷浓度的克罗恩病(CD)和溃疡性结肠炎(UC)患者的治疗反应。
共招募了65例患者(32例CD患者和33例UC患者)。CD和UC患者的总体反应率均超过80%。CD或UC患者的治疗反应和CT-P13水平无显著差异。我们未发现第6周、第10周或第12周达到3μg/mL药物浓度的患者百分比存在显著差异;在第14周观察到显著下降。在第14周CT-P13水平处于亚治疗水平的CD患者中,高达55.5%的患者和UC患者中64.3%的患者对治疗产生了主要反应。
第10周和第12周的药物水平中间测量未发现两组中任何英夫利昔单抗浓度低于治疗水平的明显下降,因此表明无临床实用性。诱导期后,尽管药物水平处于亚治疗水平,但仍有相当比例的患者对治疗产生了主要反应。