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Impact of first-line infliximab on the pharmacokinetics of second-line vedolizumab in inflammatory bowel diseases.


ABSTRACT: Background:Very little is known about the impact of the wash-out period on the pharmacokinetics of a second-line biologic. Objective:The objective of this article is to explore the impact of two different wash-out periods on the pharmacokinetics of vedolizumab and infliximab. Methods:Patients switching from infliximab to vedolizumab were retrospectively identified. The population was divided into two groups according to wash-out period: <6 weeks or >6 weeks. Vedolizumab and infliximab trough levels (TLs) were determined and correlated with clinical and biological outcomes. Results:A total of 71 inflammatory bowel disease patients were included. At week 6, in patients previously treated with infliximab, median vedolizumab TLs were 21.9?µg/ml and 24.9?µg/ml for the <6 weeks and >6 weeks wash-out period, respectively (p?=?0.31), whereas median residual infliximab TLs were 0.5?µg/ml and 0?µg/ml (p?=?0.034). The rate of treatment discontinuation was similar (p?=?0.64), and the infectious events were six and two for the <6 weeks and >6 weeks wash-out period, respectively (p?=?0.12) by week 30. Conclusions:This study suggests clinicians may not need to be concerned about the impact of wash-out period on the pharmacokinetics of the second-line biologic when switching infliximab to vedolizumab. More data are required on the impact of wash-out period on safety.

SUBMITTER: Liefferinckx C 

PROVIDER: S-EPMC6620879 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Impact of first-line infliximab on the pharmacokinetics of second-line vedolizumab in inflammatory bowel diseases.

Liefferinckx Claire C   Verstockt Bram B   Gils Ann A   Tops Sophie S   Van Moerkercke Wouter W   Vermeire Severine S   Franchimont Denis D  

United European gastroenterology journal 20190324 6


<h4>Background</h4>Very little is known about the impact of the wash-out period on the pharmacokinetics of a second-line biologic.<h4>Objective</h4>The objective of this article is to explore the impact of two different wash-out periods on the pharmacokinetics of vedolizumab and infliximab.<h4>Methods</h4>Patients switching from infliximab to vedolizumab were retrospectively identified. The population was divided into two groups according to wash-out period: <6 weeks or >6 weeks. Vedolizumab and  ...[more]

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