The effective, but expensive, drug infliximab is used in patients with inflammatory bowel disease (IBD).
Monitoring infliximab trough levels and anti-infliximab antibody formation can lead to a more cost-effective use of infliximab therapy.
Dr Margot Taks and colleagues investigated the effect of implementation of a treatment algorithm for infliximab in a single-centre IBD cohort, focussing on remission rates and drug costs.
IBD patients aged 18 years or older treated with infliximab were asked to participate in this study.
|The number of patients in remission was 85% at baseline|
|European Journal of Gastroenterology & Hepatology|
The team assessed remission rates using fecal calprotectin levels, and a validated questionnaire.
Infliximab trough levels and anti-infliximab antibodies were determined at baseline, and at the third infliximab infusion.
According to the advice given by the treatment algorithm, infliximab dosage adjustments were performed at the second infliximab infusion.
In 2015, the team treated a total of 62 IBD patients with infliximab, of whom 33 patients agreed to participate in this study.
The researchers found that the number of patients in remission was 85% at baseline, and there were 13 dose adaptations suggested by the treatment algorithm for the successive second infusion.
The team observed that 4 patients possessed undetectable infliximab levels, and positive anti-infliximab antibody status at baseline.
After the second infusion, there were 88% of patients in remission at the third infusion.
The team reports that all of this resulted in an annual drug cost reduction of €47,026, or 7%.
Dr Taks' team concludes, "Our developed treatment algorithm of infliximab led to optimization of infliximab therapy in IBD patients by increasing remission rates, and reducing drug costs."