Optimization of infliximab therapy in inflammatory bowel disease using a dashboard approach—an Indian experience.
Purpose: Infliximab (IFX) therapy in inflammatory bowel disease (IBD) is associated with loss of response in half the patients, due to complex pharmacokinetic and immunological factors. Dashboard's Bayesian algorithms use information from model and individual multivariate determinants of IFX concent...
| Published in: | European Journal of Clinical Pharmacology Vol. 77; no. 1; pp. 55 - 63 |
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| Main Authors: | , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
2021
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=147908487&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 147908487 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: 2021 vid: 77 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 147908487 145485452 147908487 147908487 10.1007/s00228-020-02975-0 147908487 ppf: 55 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Optimization of infliximab therapy in inflammatory bowel disease using a dashboard approach—an Indian experience. aug: au: Dave, Mihika B. Dherai, Alpa J. Desai, Devendra C. Mould, Diane R. Ashavaid, Tester F. affil: Department of Biochemistry, P. D. Hinduja Hospital & MRC, Veer Savarkar Marg, Mahim, 400016, Mumbai, India sug: subj: Infliximab Therapeutic Use Inflammatory Bowel Diseases Drug Therapy Infliximab Pharmacokinetics Infliximab Immunology Drug Monitoring Methods Dose-Response Relationship, Drug DASH Diet Dashboard Systems Human Comparative Studies C-Reactive Protein Albumins India ab: Purpose: Infliximab (IFX) therapy in inflammatory bowel disease (IBD) is associated with loss of response in half the patients, due to complex pharmacokinetic and immunological factors. Dashboard's Bayesian algorithms use information from model and individual multivariate determinants of IFX concentration and can predict dose and dosing interval. Aim: To compare measured IFX concentrations in our laboratory with values predicted by iDose dashboard system and report its efficacy in managing patients not responding to conventional dosing schedule. Method: Clinical history, demographic details, and laboratory findings such as albumin and C-reactive protein (CRP) data of IBD patients (n = 30; median age 23 years (IQR: 14.25 – 33.5)) referred for IFX drug monitoring in our laboratory from November 2017 to November 2019 were entered in iDose software. The IFX concentration predicted by iDose based on this information was compared with that measured in our laboratory. In addition, a prospective dashboard-guided dosing was prescribed in 11 of these 30 patients not responding to conventional dosing and was followed to assess their clinical outcome. Result: IFX monitoring in our 30 patients had shown therapeutic concentration in 12, supratherapeutic in 2 and subtherapeutic concentration in 16 patients. The iDose predicted concentration showed concordance in 21 of these 30 patients. Of 11 patients managed with iDose-assisted prospective dosing, 8 achieved clinical remission, 2 showed partial response, and one developed antibodies. Conclusion: Retrospective data analysis showed concordance between laboratory measured and iDose-predicted IFX level in 70% of patients. iDose-assisted management achieved clinical remission and cost reduction. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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