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Antibodies cross-reacting with infliximab predict safety of infliximab therapy in IBD

Pre-existing IgG antibodies cross-reacting with the Fab region of infliximab predict efficacy and safety of infliximab therapy in inflammatory bowel disease, reports June's issue of the Alimentary Pharmacology & Therapeutics.

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Infliximab is a chimeric murine/human anti-TNF antibody used for the treatment of Crohn's disease and ulcerative colitis.

Loss of response is common and associated with development of anti-Infliximab antibodys during ongoing therapy.

Dr C. Steenholdt, Y. Palarasah from Herlev, Denmark however, human anti-murine immunoglobulin Abs are common and may cross-react with the murine part of Infliximab.

To investigate if antibodys binding to Infliximab's Fab region are present in IBD patients before exposure to Infliximab, and whether they predict efficacy and safety of Infliximab therapy.

The research team noted that observational, retrospective cohort study of patients with Crohn's disease  and ulcerative colitis.

A cut-off concentration of 439 mU Infliximab-Fab reactive IgG antibody per litre comprised all patients
Alimentary Pharmacology & Therapeutics

The doctors reported that Pre-treatment levels of Infliximab-Fab reactive IgG antibodys were significantly lower in Crohn's disease patients in remission after 1 year of maintenance Infliximab than in the rest of the patients, and lower

than in patients with secondary loss of response in particular.

A cut-off concentration of 439 mU Infliximab-Fab reactive IgG antibody per litre comprised all patients who later obtained long-term sustained remission on Infliximab.

Dr Steenholdt's team commented "Similar trends were observed in ulcerative colitis."

"The pre-treatment levels of Infliximab-Fab reactive IgG antibodys were markedly higher in patients developing infusion reactions to Infliximab than in the remaining patients."

Aliment Pharmacol Ther 2013: 37(12) : 1172–1183
07 June 2013

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