Infliximab in young paediatric IBD patients: it is all about the dosing

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11130%2F20%3A10413528" target="_blank" >RIV/00216208:11130/20:10413528 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064203:_____/20:10413528

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=8-mmOqpTBa" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=8-mmOqpTBa</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00431-020-03750-0" target="_blank" >10.1007/s00431-020-03750-0</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Infliximab in young paediatric IBD patients: it is all about the dosing

Popis výsledku v původním jazyce

Infliximab (IFX) is administered intravenously using weight-based dosing (5 mg/kg) in inflammatory bowel disease (IBD) patients. Our hypothesis is that especially young children need a more intensive treatment regimen than the current weight-based dose administration. We aimed to assess IFX pharmacokinetics (PK), based on existing therapeutic drug monitoring (TDM) data in IBD patients &lt; 10 years. TDM data were collected retrospectively in 14 centres. Children treated with IFX were included if IFX was started as IBD treatment at age &lt; 10 years (young patients, YP) and PK data were available. Older IBD patients aged 10-18 years were used as controls (older patients, OP). Two hundred and fifteen paediatric inflammatory bowel disease (PIBD) patients were eligible for the study (110 &lt; 10 year; 105 &gt;= 10 years). Median age was 8.3 years (IQR 6.9-8.9) in YP compared with 14.3 years (IQR 12.8-15.6) in OP at the start of IFX. At the start of maintenance treatment, 72% of YP had trough levels below therapeutic range (&lt; 5.4 μg/mL). After 1 year of scheduled IFX maintenance treatment, YP required a significantly higher dose per 8 weeks compared with OP (YP; 9.0 mg/kg (IQR 5.0-12.9) vs. OP; 5.5 mg/kg (IQR 5.0-9.3); p &lt; 0.001). The chance to develop antibodies to infliximab was relatively lower in OP than YP (0.329 (95% CI - 1.2 to - 1.01); p &lt; 0.001), while the overall duration of response to IFX was not significantly different (after 2 years 53% (n = 29) in YP vs. 58% (n = 45) in OP; p = 0.56).Conclusion: Intensification of the induction scheme is suggested for PIBD patients aged &lt; 10 years. What is Known? .Infliximab trough levels of paediatric IBD patients are influenced by several factors as dosing scheme, antibodies and inflammatory markers. .In 4.5-30% of the paediatric IBD patients, infliximab treatment was stopped within the first year. What is New? .The majority of young PIBD (&lt; 10 years) have inadequate IFX trough levels at the start of maintenance treatment. .Young PIBD patients (&lt; 10 years) were in need of a more intensive treatment regimen compared with older paediatric patients during 1 year of IFX treatment. .The chance to develop antibodies to infliximab was relatively higher in young PIBD patients (&lt; 10 years).

Název v anglickém jazyce

Infliximab in young paediatric IBD patients: it is all about the dosing

Popis výsledku anglicky

Infliximab (IFX) is administered intravenously using weight-based dosing (5 mg/kg) in inflammatory bowel disease (IBD) patients. Our hypothesis is that especially young children need a more intensive treatment regimen than the current weight-based dose administration. We aimed to assess IFX pharmacokinetics (PK), based on existing therapeutic drug monitoring (TDM) data in IBD patients &lt; 10 years. TDM data were collected retrospectively in 14 centres. Children treated with IFX were included if IFX was started as IBD treatment at age &lt; 10 years (young patients, YP) and PK data were available. Older IBD patients aged 10-18 years were used as controls (older patients, OP). Two hundred and fifteen paediatric inflammatory bowel disease (PIBD) patients were eligible for the study (110 &lt; 10 year; 105 &gt;= 10 years). Median age was 8.3 years (IQR 6.9-8.9) in YP compared with 14.3 years (IQR 12.8-15.6) in OP at the start of IFX. At the start of maintenance treatment, 72% of YP had trough levels below therapeutic range (&lt; 5.4 μg/mL). After 1 year of scheduled IFX maintenance treatment, YP required a significantly higher dose per 8 weeks compared with OP (YP; 9.0 mg/kg (IQR 5.0-12.9) vs. OP; 5.5 mg/kg (IQR 5.0-9.3); p &lt; 0.001). The chance to develop antibodies to infliximab was relatively lower in OP than YP (0.329 (95% CI - 1.2 to - 1.01); p &lt; 0.001), while the overall duration of response to IFX was not significantly different (after 2 years 53% (n = 29) in YP vs. 58% (n = 45) in OP; p = 0.56).Conclusion: Intensification of the induction scheme is suggested for PIBD patients aged &lt; 10 years. What is Known? .Infliximab trough levels of paediatric IBD patients are influenced by several factors as dosing scheme, antibodies and inflammatory markers. .In 4.5-30% of the paediatric IBD patients, infliximab treatment was stopped within the first year. What is New? .The majority of young PIBD (&lt; 10 years) have inadequate IFX trough levels at the start of maintenance treatment. .Young PIBD patients (&lt; 10 years) were in need of a more intensive treatment regimen compared with older paediatric patients during 1 year of IFX treatment. .The chance to develop antibodies to infliximab was relatively higher in young PIBD patients (&lt; 10 years).

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30209 - Paediatrics

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2020

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

European Journal of Pediatrics

ISSN

0340-6199

e-ISSN

—

Svazek periodika

179

Číslo periodika v rámci svazku

12

Stát vydavatele periodika

DE - Spolková republika Německo

Počet stran výsledku

10

Strana od-do

1935-1944

Kód UT WoS článku

000560990300002

EID výsledku v databázi Scopus

2-s2.0-85089569797