The following is a summary of “Influence of subclinical active inflammation on IFX pharmacokinetic modeling and disease progression assessment: findings from a prospective real-world study in inflammatory bowel disease patients,” published in the January 2024 issue of Gastroenterology by Magro et al.
Understanding how infliximab (IFX) behaves in the body is crucial for effectively managing inflammatory bowel disease (IBD).
Researchers started a retrospective study to build a reliable infliximab (IFX) pharmacokinetics (PK) model in IBD, pinpointing factors affecting its clearance (CL) and assessing disease progression risks during maintenance therapy.
They conducted the multicenter, prospective, real-world DIRECT study across multiple care centers, involving 369 IBD patients in the maintenance phase of IFX therapy. Employing a two-compartment PK model, IFX CL and covariates were determined. Logistic and Cox regressions revealed associations between disease progression and covariates integrated into the PK model.
The results showed that the PK model factored in weight, albumin, anti-drug antibody (ADA), and fecal calprotectin (FC). On average, elevated ADA, FC concentration, weight, and lower albumin concentration increased IFX CL. In the multivariate regression analyses, FC levels influenced disease progression odds across various definitions, adjusted for several confounding factors. Notably, IFX and CL significantly impacted the temporal aspect of disease progression alongside FC.
Investigators concluded that FC-guided infliximab dosing in IBD offers personalized treatment by linking drug levels and disease progression.
Source: academic.oup.com/ecco-jcc/advance-article-abstract/doi/10.1093/ecco-jcc/jjae014/7579347