title: Pharmacokinetics of Infliximab and Reduction of Treatment for Inflammatory Bowel Diseases.
abstract: Local or national policy, patients' preferences, safety and/or economic concerns, or reimbursement issues may dictate stopping drug in inflammatory bowel diseases (IBD) patients. Sustained deep remission is an important predictor of a better outcome after anti-tumor necrosis (TNF) factor therapy discontinuation, including infliximab (IFX) in IBD patients, but this is not sufficient to prevent future relapse in these patients. In IBD patients under combotherapy, trough level of infliximab (TRI) could be helpful to choose stopping one of the two drugs. In patients on IFX monotherapy, TRI could help to decide reduction of drug dosing, particularly in IBD patients with supratherapeutic trough levels. Incidental findings of undetectable TRI in patients with deep remission may identify a subset of patients who may be considered for IFX cessation. Controlled trials further assessing this issue are eagerly awaited. Pending these trials, clear international recommendations for discontinuing anti-TNF therapy are needed.
authors.affiliation: CIC Inserm et Service d'Hépato-gastroentérologie, Hôpital Universitaire de Saint Etienne, Université Jean Monnet, Avenue Albert Raimond, 4227, Saint Priest en Jarez, France. Nicolas.Williet@chu-st-etienne.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Williet
authors.affiliation: Service Immunopharmacologie Hôpital Universitaire de Saint Etienne, Université Jean Monnet, Saint Priest en Jarez, France.
authors.forename: Stephane
authors.initials: S
authors.lastname: Paul
authors.affiliation: Inserm, U954 et Service d'Hepato-Gastroenterologie, CHU de Nancy, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
authors.affiliation: CIC Inserm et Service d'Hépato-gastroentérologie, Hôpital Universitaire de Saint Etienne, Université Jean Monnet, Avenue Albert Raimond, 4227, Saint Priest en Jarez, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Roblin
mesh_terms: D000465:Algorithms; D004359:Drug Therapy, Combination; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D000069285:Infliximab / Q000008:administration & dosage* / Q000493:pharmacokinetics
chemical_list: D005765:Gastrointestinal Agents; D000069285:Infliximab
keywords: De-escalation; Inflammatory bowel disease; Infliximab; Pharmacokinetics; Reduction; Trough level of infliximab