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Influence of albuminemia on the pharmacokinetics of infliximab in patients with inflammatory bowel diseases


Authors: K. Malíčková 1;  M. Bortlík 2,3;  D. Ďuricová 2 ;  H. Brodská 1;  N. Machková 2;  I. Janatková 1;  T. Zima 1;  M. Lukáš 1,2
Authors place of work: Ústav klinické biochemie a laboratorní diagnostiky 1. LF UK a VFN Praha 1;  Klinické a výzkumné centrum pro střevní záněty, ISCARE Lighthouse a 1. LF UK Praha3Interní klinika 1. LF UK a ÚVN Praha 2
Published in the journal: Gastroent Hepatol 2011; 65(2): 70-74
Category: IDB: Original Article

Summary

Purpose of the study:
To analyse infliximab and albumin serum levels in different stages of the biological treatment of patients with inflammatory bowel diseases (IBD).

Methods:
We examined the serum trough levels of infliximab and albuminemia in 85 patients with IBD in weeks 2 and 14 of biological treatment with infliximab.

Results:
In week 2, infliximab was detected in the sera of 34 patients (40%) and in week 14 in 44 patients (52%). Serum infliximab trough levels were significantly lower in week 2 than in week 14 (p = 0.0138). Likewise, levels of albumin in week 2 were significantly lower than in week 14 (p = 0.0002). In patients with detectable serum infliximab trough levels (concentration ≥ 3 mg/mL), albuminemia was significantly higher than in patients with undetectable serum infliximab levels, regardless of the biological treatment stage. The correlation between serum infliximab levels and albuminemia was significantly positive (r = 0.39, p < 0.0001).

Conclusions:
Levels of both infliximab and albumin rise during bio­logical treatment of IBD. We confirmed a significant positive correlation between albumin and infliximab serum levels, suggesting the theoretical possibility of using serum albumin to predict infliximab pharmacokinetics.

Key words:
inflammatory bowel diseases – biological therapy – infliximab – albumin


Zdroje

1. Lukáš M. Biologická terapie a idiopatické střevní záněty. Současný stav a výhled do budoucnosti. Čes a Slov Gastroent a Hepatol 2005; 59(5): 217–226.

2. Licastro F, Chiappelli M, Ianni M et al. Tumor necrosis factor-alpha antagonists: differential clinical effects by different biotechnological molecules. Int J Immunopathol Pharmacol 2009; 22(3): 567–572.

3. Shah B, Mayer L. Current status of mono­clonal antibody therapy for the treatment of inflammatory bowel disease. Expert Rev Clin Immunol 2010; 6(4): 607–620.

4. Klotz U, Teml A, Schwab M. Clinical pharmacokinetics and use of infliximab. Clin Pharmacokinet 2007; 46(8): 645–660.

5. Svenson M, Geborek P, Saxne T et al. Monitoring patients treated with anti-TNF-alpha biopharmaceuticals: assessing serum infliximab and anti-infliximab antibodies. Rheumatology (Oxford) 2007; 46(12): 1828–1834.

6. Fasanmade AA, Adedokun OJ, Ford J et al. Population pharmacokinetic analysis of infliximab in patients with ulcerative colitis. Eur J Clin Pharmacol 2009; 65(12): 1211–1228.

7. Bendtzen K, Ainsworth M, Steenholdt C et al. Individual medicine in inflammatory bowel disease: monitoring bioavailability, pharmacokinetics and immuno­genicity of anti-tumour necrosis factor-alpha antibodies. Scand J Gastroenterol 2009; 44(7): 774–781.

8. Ternant D, Aubourg A, Magdelaine-Beuzelin C et al.Infliximab pharmacokinetics in inflammatory bowel disease patients. Ther Drug Monit 2008; 30(4): 523–529.

9. Lichtenstein GR, Diamond RH, Wagner CL et al. Clinical trial: benefits and risks of immunomodulators and maintenance infliximab for IBD-subgroup analyses across four randomized trials. Aliment Pharmacol Ther 2009; 30(3): 210–226.

10. Tracey D, Klareskog L, Sasso EH at al. Tumor necrosis factor antagonist mechanisms of action: a comprehensive review. Pharmacol Ther 2008; 117(2): 244–279.

11. Magro F, Bastos R, Marques M et al. Infliximab dose intensification by shortening infusion intervals. Inflamm Bowel Dis 2008; 14(3): 432–434.

12. Fasanmade AA, Adedokun OJ, Olson A et al. Serum albumin concentration: a predictive factor of infliximab pharmacokinetics and clinical response in patients with ulcerative colitis. Int J Clin Pharmacol Ther 2010; 48(5): 297–308.

13. Koelewijn CL, Schwartz MP, Samsom M et al. C-reactive protein levels during a relapse of Crohn‘s disease are associated with the clinical course of the disease. World J Gastroenterol 2008; 14(1): 85–89.

14. Sokol H, Seksik P, Carrat F et al. Usefulness of co-treatment with immunomodulators in patients with inflammatory bowel disease treated with scheduled infliximab maintenance therapy. Gut 2010; 59(10): 1363–1368.

15. Lukáš M, Ďuricová D, Bortlík M et al. Doporučení pro podávání biologické terapie u idiopatických střevních zánětů. Čes a Slov Gastroent a Hepatol 2008; 62(5): 285–291.

16. Maser EA, Villela R, Silverberg MS et al. Association of trough serum infliximab to clinical outcome after scheduleded maintenance treatment for Crohns disease. Clin Gastroenterol Hepatol 2006; 4(10): 1248–1254.

17. Schnitzler F, Fidder H, Ferrante M et al. Mucosal healing predicts long-term outcome of maintenance therapy with infliximab in Crohn‘s disease. Inflamm Bowel Dis 2009; 15(9): 1295–1301.

18. Lukáš M, Bortlík M. Je biologická léčba idiopatických střevních zánětů definitivním řešením? Aneb deset poznámek k biologické léčbě. Čes a Slov Gastroent a Hepatol 2007; 61(6): 293–296.

19. Chaudhury C, Mehnaz S, Robinson JM et al. The major histocompatibility complex-related Fc receptor for IgG (FcRn) binds albumin and prolongs its lifespan. J Exp Med 2003; 197(3): 315–322.

20. Kuo TT, Baker K, Yoshida M et al. Neonatal Fc receptor: from immunity to therapeutics. J Clin Immunol 2010; 30(6): 777–789.

21. Anderson CL, Chaudhury C, Kim J et al. Perspective-- FcRn transports albumin: relevance to immunology and medicine. Trends Immunol 2006; 27(7): 343–348.

22. Sandborn WJ, Rutgeerts P, Reinish W et al. One year data from the SONIC study: A Randomized, Double-Blind Trial Comparing Infliximab and Infliximab plus Azathioprine to Azathioprine in Patients with Crohn‘s Disease Naive to Immunomodulators and Biologic Therapy. Gastroenterology 2009; 136 (Suppl. 1): A116.

23. Lukáš M, Bortlík M. Infliximab a/nebo azathioprin u nemocných s Crohnovou chorobou Komentovaný referát ke studii SONIC. Remedia 2009; 19(5): 381–384.

24. Chalupná P, Lukáš M, Šroubková R et al. 6-thioguanine therapy in inflammatory bowel disease. Folia Gastroenterol Hepatol 2004; 2(3): 112–120.

25. Moeslinger T, Friedl R, Spieckermann PG. Inhibition of inducible nitric oxide synthesis by azathioprine in a macrophage cell line. Life Sci 2006; 79(4): 374–381.

Štítky
Paediatric gastroenterology Gastroenterology and hepatology Surgery

Článok vyšiel v časopise

Gastroenterology and Hepatology

Číslo 2

2011 Číslo 2
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