title: Serum-Infliximab Trough Levels in 45 Children with Inflammatory Bowel Disease on  Maintenance Treatment.
abstract: The role of trough serum infliximab (s-IFX) and antibodies toward IFX (ATI) during maintenance treatment remains unclear in children. The aim of the present study was to investigate trough s-IFX and ATI to identify any correlation with inflammatory activity and clinical response in a pediatric inflammatory bowel disease (IBD) cohort. We investigated the s-IFX trough levels in pediatric IBD patients (n= 45) on maintenance IFX treatment. Ninety-three blood samples were collected and demographics, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and albumin were recorded. The mean s-IFX trough level was 5.2 µg/mL. The mean trough s-IFX level was significantly higher in the samples taken during remission (7.2 µg/mL) compared to active disease (4.5 µg/mL,p< 0.05). The trough s-IFX levels correlated with ESR, CRP, and albumin. S-IFX was undetectable in eight of the patients, all with positive ATI and active disease. Surprisingly, clinical and biochemical remission was observed at only 26 of the 93 visits. The correlation between dose variations and changes in trough s-IFX was not evident. In line with studies in adults, the s-IFX trough levels correlated with response to infliximab.
authors.affiliation: Department of Gastroenterology, Sachs' Children and Youth Hospital, SE-11883 Stockholm, Sweden. helena.jonsson.rolandsdotter@ki.se.|Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, SE-11883 Stockholm, Sweden. helena.jonsson.rolandsdotter@ki.se.
authors.forename: Helena
authors.initials: H
authors.lastname: Rolandsdotter
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, SE-17776 Stockholm, Sweden. per.marits@sll.se.|Department of Medicine Solna, Karolinska Institute, SE-17776 Stockholm, Sweden. per.marits@sll.se.
authors.forename: Per
authors.initials: P
authors.lastname: Marits
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, SE-17776 Stockholm, Sweden. ulf.sundin.49@gmail.com.
authors.forename: Ulf
authors.initials: U
authors.lastname: Sundin
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, SE-17776 Stockholm, Sweden. ann-charlotte.wikstrom@sll.se.|Department of Medicine Solna, Karolinska Institute, SE-17776 Stockholm, Sweden. ann-charlotte.wikstrom@sll.se.
authors.forename: Ann-Charlotte
authors.initials: AC
authors.lastname: Wikström
authors.affiliation: Department of Women's and Children's Health, Karolinska Institute, SE-11776 Stockholm, Sweden. ulrika.fagerberg@regionvastmanland.se.|Center for Clinical Research and Department of Pediatrics, Västmanland Hospital Vasteras, SE-72189 Västerås, Sweden. ulrika.fagerberg@regionvastmanland.se.
authors.forename: Ulrika L
authors.initials: UL
authors.lastname: Fagerberg
authors.affiliation: Department of Gastroenterology, Sachs' Children and Youth Hospital, SE-11883 Stockholm, Sweden. yigael.finkel@ki.se.|Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, SE-11883 Stockholm, Sweden. yigael.finkel@ki.se.
authors.forename: Yigael
authors.initials: Y
authors.lastname: Finkel
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, SE-11883 Stockholm, Sweden. michael.eberhardson@ki.se.|Department of Gastroenterology, Danderyds Hospital, SE-18288 Stockholm, Sweden. michael.eberhardson@ki.se.
authors.forename: Michael
authors.initials: M
authors.lastname: Eberhardson
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000493:pharmacokinetics*; D002648:Child; D002675:Child, Preschool; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D000069285:Infliximab / Q000493:pharmacokinetics*; D008297:Male; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000069285:Infliximab
keywords: Crohn’s disease; antibodies toward infliximab; inflammatory bowel disease; trough levels; ulcerative colitis