Dataset Information

High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease.

ABSTRACT:

Background and aim

While weight gain during infliximab therapy in inflammatory bowel disease (IBD) is common, there has been limited research evaluating its impact on infliximab efficacy.

Methods

Primary aims of this study were to determine the frequency of excess weight gain (body mass index [BMI]?>?25?kg/m²) in children with IBD on maintenance infliximab and evaluate the impact on infliximab dosing, serum trough levels, and treatment failure. Secondary aims were to determine differences in weight gain, treatment characteristics, and clinical/biochemical variables between patients with therapeutic and subtherapeutic maintenance therapy trough levels. We performed a retrospective study of 253 pediatric IBD (75.1% Crohn's disease, 23.3% ulcerative colitis, 1.6% IBD-unclassified) patients on infliximab followed at BC Children's Hospital between January 2013 and January 2018.

Results

Median age at infliximab initiation was 13.9?years, median length of follow up was 56.9 months, and 55.7% were males; 10.3% of the cohort demonstrated excess weight gain (7.5% overweight, 2.8% obese). Average mg/kg dosing was not statistically different between groups (normal, overweight, and obese: 6.7, 6.4, and 6.7 mg/kg, respectively, P = 0.52). Median BMI of patients with therapeutic and subtherapeutic trough levels was similar at 19.9 kg/m² (interquartile range [IQR], 17.3-23.8) and 19.7 kg/m² (IQR, 17.4-21.9), respectively. BMI had no effect on secondary loss of response to infliximab, with no significant difference between normal and high BMI subgroups (13.4 vs. 16.7%, P = 0.9).

Conclusions

In a subgroup of pediatric IBD patients on maintenance infliximab, excess weight gain was not associated with higher weight-based dosing, lower serum trough levels, or increased risk of treatment failure.

SUBMITTER: Rodin I

PROVIDER: S-EPMC7273726 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Publications

High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease.

Rodin Isaac I Chan Justin J Meleady Laura L Hii Clare C Lawrence Sally S Jacobson Kevan K

JGH open : an open access journal of gastroenterology and hepatology 20191123 3

<h4>Background and aim</h4>While weight gain during infliximab therapy in inflammatory bowel disease (IBD) is common, there has been limited research evaluating its impact on infliximab efficacy.<h4>Methods</h4>Primary aims of this study were to determine the frequency of excess weight gain (body mass index [BMI] > 25 kg/m<sup>2</sup>) in children with IBD on maintenance infliximab and evaluate the impact on infliximab dosing, serum trough levels, and treatment failure. Secondary aims were to de ...[more]

PMID: 32514452

Similar Datasets

Project description:BackgroundMany pediatric patients with inflammatory bowel disease (IBD) lose response to infliximab (IFX) within the first year, and achieving a minimal target IFX trough concentration is associated with higher remission rates and longer durability. Population pharmacokinetic (PK) modeling can predict trough concentrations for individualized dosing. The object of this study was to refine a population PK model that accurately predicts individual IFX exposure during maintenance therapy using longitudinal real-practice data.MethodsWe exported data from the electronic health records of pediatric patients with IBD treated with originator IFX at a single center between January 2011 and March 2017. Subjects were divided into discovery and validation cohorts. A population PK model was built and then validated.ResultsWe identified 228 pediatric patients with IBD who received IFX and had at least 1 drug concentration measured, including 135 and 93 patients in the discovery and validation cohorts, respectively. Weight, albumin, antibodies to IFX (ATI) detected by a drug-tolerant assay, and erythrocyte sedimentation rate (ESR) were identified as covariates significantly associated with IFX clearance and incorporated into the model. The model exhibited high accuracy for predicting target IFX trough concentrations with an area under the receiver operating characteristic curve (AUROC) of 0.86 (95% confidence interval [CI], 0.81-0.91) for population-based predictions without prior drug-level input. Accuracy increased further for individual-based predictions when prior drug levels were known, with an AUROC of 0.93 (95% CI, 0.90-0.97).ConclusionsA population PK model utilizing weight, albumin, ordinal drug-tolerant ATI, and ESR accurately predicts IFX trough concentrations during maintenance therapy in real-practice pediatric patients with IBD. This model, which incorporates dynamic clinical information, could be used for individualized dosing decisions to increase response durability.

Dataset Information

High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease.

Background and aim

Methods

Results

Conclusions

Publications

High body mass index is not associated with increased treatment failure in infliximab treated pediatric patients with inflammatory bowel disease.

Similar Datasets

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