Serum trough levels of infliximab are not associated with peripheral arthralgia activity in patients with inflammatory bowel disease. BMJ Open Gastroenterol 2021 Nov;8(1)
Date
11/13/2021Pubmed ID
34764142Pubmed Central ID
PMC8587383DOI
10.1136/bmjgast-2021-000788Scopus ID
2-s2.0-85119838983 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND: Infliximab is an efficacious therapy for inflammatory bowel disease and may play a role in management of some extraintestinal manifestations. While higher trough levels of infliximab are associated with higher rates of disease remission, the association between trough levels of infliximab and arthralgia activity characterised as an extraintestinal manifestation has yet to be defined.
OBJECTIVE: We aimed to assess the association between serum trough levels of infliximab and peripheral arthralgia activity in patients with inflammatory bowel disease.
DESIGN: In this cross-sectional study, we identified patients with inflammatory bowel disease on infliximab therapy with known history of arthralgias attributed to an extraintestinal manifestation. Collected variables included disease phenotype, medications (such as thiopurines or methotrexate), Harvey Bradshaw Index, partial Mayo score, C reactive protein, trough levels of infliximab and anti-infliximab antibodies. The primary outcome was active patient-reported arthralgia.
RESULTS: Out of 267 patients included, 65 (24.4%) had active arthralgias at the time the trough level of infliximab was measured. No significant differences in trough levels were seen between those patients with and without arthralgias. Patients on combination therapy with methotrexate or thiopurines or those with detectable anti-infliximab antibodies were not more likely to have inactive arthralgias (OR 0.99, 95% CI 0.57 to 1.74, p=0.99 and OR 1.94, 95% CI 0.9 to 4.1, p=0.09, respectively).
CONCLUSIONS: This study suggests that although therapeutic drug monitoring of infliximab can have a role in the management of Crohn's disease and ulcerative colitis, it does not seem to be useful in managing arthralgias associated with inflammatory bowel disease.
Author List
Sekhri S, Rao B, Mohananey A, Beniwal-Patel P, Bruss A, Stein DJ, Yarur AJAuthors
Poonam Beniwal-Patel MD Associate Professor in the Medicine department at Medical College of WisconsinDaniel J. Stein MD Director, Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
ArthralgiaChronic Disease
Cross-Sectional Studies
Humans
Immunologic Factors
Inflammatory Bowel Diseases
Infliximab
Methotrexate
