Advanced search
1 file | 677.90 KB Add to list

Review article: dose optimisation of infliximab for acute severe ulcerative colitis

Author
Organization
Abstract
Background : Although optimal medical management of acute severe ulcerative colitis (UC) is ill-defined, infliximab has become a standard of care. Accumulating evidence suggests an increased rate of infliximab clearance in patients with acute severe UC and a reduced colectomy rate with an intensified infliximab induction regimen. Aim : To assess the strength of the current evidence for the relationship between infliximab pharmacokinetics, dosing strategies and disease behaviour in patients with acute severe UC. Methods : We systematically searched MEDLINE and conference proceedings from 2000 to 2016 for relevant articles describing the pharmacokinetics of infliximab in acute severe UC and/or infliximab dose intensification strategies in acute severe UC. Eligible articles described randomised controlled trials, and cohort, cross-sectional, and case-controlled studies. Results : Of 400 citations identified, 76 studies were eligible. Increased infliximab clearance occurs in patients with acute severe UC, and is driven by the total inflammatory burden and leakage of drug into the colonic lumen. Several cohort studies suggest that infliximab dose intensification is beneficial to at least 50% of acute severe UC patients and the results of case-controlled studies indicate that an intensified infliximab dosing regimen with 1-2 additional infusions in the first 3 weeks of treatment could reduce the early (3-month) colectomy rate by up to 80%, although these data require prospective validation. Conclusions : Uncontrolled studies suggest a benefit for infliximab dose optimisation in patients with acute severe UC. A randomised controlled trial in acute severe UC patients comparing a personalised infliximab dose-optimisation strategy with conventional dosing is a research priority.
Keywords
INFLAMMATORY-BOWEL-DISEASE, EVIDENCE-BASED CONSENSUS, FECAL CALPROTECTIN LEVELS, TUMOR-NECROSIS-FACTOR, TERM-FOLLOW-UP, CROHNS-DISEASE, INDUCTION THERAPY, RESCUE THERAPY, CURRENT MANAGEMENT, CLINICAL-RESPONSE

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 677.90 KB

Citation

Please use this url to cite or link to this publication:

MLA
Hindryckx, Pieter, G Novak, N Vande Casteele, et al. “Review Article: Dose Optimisation of Infliximab for Acute Severe Ulcerative Colitis.” ALIMENTARY PHARMACOLOGY & THERAPEUTICS 45.5 (2017): 617–630. Print.
APA
Hindryckx, P., Novak, G., Vande Casteele, N., Laukens, D., Parker, C., Shackelton, L., Narula, N., et al. (2017). Review article: dose optimisation of infliximab for acute severe ulcerative colitis. ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 45(5), 617–630.
Chicago author-date
Hindryckx, Pieter, G Novak, N Vande Casteele, Debby Laukens, C Parker, LM Shackelton, N Narula, et al. 2017. “Review Article: Dose Optimisation of Infliximab for Acute Severe Ulcerative Colitis.” Alimentary Pharmacology & Therapeutics 45 (5): 617–630.
Chicago author-date (all authors)
Hindryckx, Pieter, G Novak, N Vande Casteele, Debby Laukens, C Parker, LM Shackelton, N Narula, R Khanna, P Dulai, BG Levesque, WJ Sandborn, G D’Haens, BG Feagan, and V Jairath. 2017. “Review Article: Dose Optimisation of Infliximab for Acute Severe Ulcerative Colitis.” Alimentary Pharmacology & Therapeutics 45 (5): 617–630.
Vancouver
1.
Hindryckx P, Novak G, Vande Casteele N, Laukens D, Parker C, Shackelton L, et al. Review article: dose optimisation of infliximab for acute severe ulcerative colitis. ALIMENTARY PHARMACOLOGY & THERAPEUTICS. 2017;45(5):617–30.
IEEE
[1]
P. Hindryckx et al., “Review article: dose optimisation of infliximab for acute severe ulcerative colitis,” ALIMENTARY PHARMACOLOGY & THERAPEUTICS, vol. 45, no. 5, pp. 617–630, 2017.
@article{8518639,
  abstract     = {Background : Although optimal medical management of acute severe ulcerative colitis (UC) is ill-defined, infliximab has become a standard of care. Accumulating evidence suggests an increased rate of infliximab clearance in patients with acute severe UC and a reduced colectomy rate with an intensified infliximab induction regimen. 
Aim : To assess the strength of the current evidence for the relationship between infliximab pharmacokinetics, dosing strategies and disease behaviour in patients with acute severe UC. 
Methods : We systematically searched MEDLINE and conference proceedings from 2000 to 2016 for relevant articles describing the pharmacokinetics of infliximab in acute severe UC and/or infliximab dose intensification strategies in acute severe UC. Eligible articles described randomised controlled trials, and cohort, cross-sectional, and case-controlled studies. 
Results : Of 400 citations identified, 76 studies were eligible. Increased infliximab clearance occurs in patients with acute severe UC, and is driven by the total inflammatory burden and leakage of drug into the colonic lumen. Several cohort studies suggest that infliximab dose intensification is beneficial to at least 50% of acute severe UC patients and the results of case-controlled studies indicate that an intensified infliximab dosing regimen with 1-2 additional infusions in the first 3 weeks of treatment could reduce the early (3-month) colectomy rate by up to 80%, although these data require prospective validation. 
Conclusions : Uncontrolled studies suggest a benefit for infliximab dose optimisation in patients with acute severe UC. A randomised controlled trial in acute severe UC patients comparing a personalised infliximab dose-optimisation strategy with conventional dosing is a research priority.},
  author       = {Hindryckx, Pieter and Novak, G and Vande Casteele, N and Laukens, Debby and Parker, C and Shackelton, LM and Narula, N and Khanna, R and Dulai, P and Levesque, BG and Sandborn, WJ and D'Haens, G and Feagan, BG and Jairath, V},
  issn         = {0269-2813},
  journal      = {ALIMENTARY PHARMACOLOGY & THERAPEUTICS},
  keywords     = {INFLAMMATORY-BOWEL-DISEASE,EVIDENCE-BASED CONSENSUS,FECAL CALPROTECTIN LEVELS,TUMOR-NECROSIS-FACTOR,TERM-FOLLOW-UP,CROHNS-DISEASE,INDUCTION THERAPY,RESCUE THERAPY,CURRENT MANAGEMENT,CLINICAL-RESPONSE},
  language     = {eng},
  number       = {5},
  pages        = {617--630},
  title        = {Review article: dose optimisation of infliximab for acute severe ulcerative colitis},
  url          = {http://dx.doi.org/10.1111/apt.13913},
  volume       = {45},
  year         = {2017},
}

Altmetric
View in Altmetric
Web of Science
Times cited: