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Anti‐TNF Monoclonal Antibodies in Inflammatory Bowel Disease: Pharmacokinetics‐Based Dosing Paradigms
Author(s) -
Ordás I,
Mould D R,
Feagan B G,
Sandborn W J
Publication year - 2012
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.2011.328
Subject(s) - medicine , ulcerative colitis , monoclonal antibody , inflammatory bowel disease , pharmacokinetics , immunogenicity , immunology , crohn's disease , dosing , immune system , disease , concomitant , antibody , inflammation , tumor necrosis factor alpha , pharmacology
Crohn's disease and ulcerative colitis are chronic inflammatory disorders resulting from immune dysregulation. Patients who fail conventional medical therapy require biological treatment with monoclonal antibodies (mAbs). Although mAbs are highly effective for induction and maintenance of clinical remission, not all patients respond, and a high proportion of patients lose response over time. One factor associated with loss of response is immunogenicity, whereby the production of antidrug antibodies accelerates mAb clearance. However, other factors related to patient and disease characteristics also influence the pharmacokinetics of mAbs. These factors include gender, body size, concomitant use of immunosuppressive agents, disease type, serum albumin concentration, and the degree of systemic inflammation. Because it is important to maintain clinically effective concentrations to provide optimal clinical response and drug exposure is affected by patient factors, a better understanding of the pharmacology of mAbs will ultimately result in better patient care. Clinical Pharmacology & Therapeutics (2012); 91 4, 635–646. doi: 10.1038/clpt.2011.328