Premium
Therapeutic drug monitoring was helpful in guiding the decision‐making process for children receiving infliximab for inflammatory bowel disease
Author(s) -
Deora Vini,
Kozak Justin,
ElKalla Mohamed,
Huynh Hien Q.,
ElMatary Wael
Publication year - 2017
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14008
Subject(s) - medicine , infliximab , therapeutic drug monitoring , inflammatory bowel disease , adalimumab , disease , trough level , drug , ulcerative colitis , pharmacokinetics , pharmacology , transplantation , tacrolimus
Aim This study examined the impact of therapeutic drug monitoring ( TDM ) on clinical decision‐making for children receiving infliximab for inflammatory bowel disease ( IBD ). Methods The medical records of children with IBD who had infliximab trough levels ( ITL s) measured between January 2013 and December 2015 at two Canadian tertiary‐care centres were examined. The indications for TDM , clinical and laboratory disease activity indices and TDM ‐driven treatment changes to infliximab therapy were documented. Results We included 107 consecutive serum measurements of ITL s in 73 children (40 boys), with a median age of 16.1 years, including 52 with Crohn's disease. TDM was performed due to concerns about clinical disease activity in 24/107 (22.4%) measurements and 83 (77.6%) were ordered as routine tests. Of these, 38 (35.5%) ITL s were suboptimal (<3.5 μg/mL) and 36 (34.0%) resulted in more frequent doses of infliximab, with subsequent improvements in disease biomarkers. Interval changes were implemented as a result of 34 (32.0%) ITL s, with shorter intervals in 19 (17.0%) cases, and seven (6.5%) ITL s resulted in adding or increasing doses of immunomodulators. In addition, four children were switched to adalimumab. Conclusion Therapeutic drug monitoring was helpful in guiding the decision‐making process for children with IBD on infliximab.