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Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infliximab therapy in patients with rheumatoid arthritis

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/62831

Title: Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infliximab therapy in patients with rheumatoid arthritis
Authors: Takeuchi, Tsutomu Browse this author →KAKEN DB
Miyasaka, Nobuyuki Browse this author →KAKEN DB
Tatsuki, Yoshihiko Browse this author
Yano, Toshiro Browse this author
Yoshinari, Toru Browse this author
Abe, Tohru Browse this author →KAKEN DB
Koike, Takao Browse this author →KAKEN DB
Issue Date: Jul-2011
Publisher: BMJ Publishing Group
Journal Title: Annals of the Rheumatic Diseases
Volume: 70
Issue: 7
Start Page: 1208
End Page: 1215
Publisher DOI: 10.1136/ard.2011.153023
Abstract: Objectives: To investigate the possible role of baseline plasma tumour necrosis factor alpha levels (baseline-TNF) on the clinical response to infliximab in patients with rheumatoid arthritis (RA). Methods: Patients with RA refractory to methotrexate received 3, 6, or 10 mg/kg of infliximab every 8 weeks, in a randomised, double-blind manner: the RISING study. Clinical response (disease activity score in 28 joints based on C-reactive protein or American College of Rheumatology core set) at week 54 and serum infliximab levels were compared in three patient groups with low, intermediate, or high baseline-TNF (TNF-low, TNF-int, or TNF-high). Results: In TNF-low patients, the clinical response to different doses of infliximab was comparable, whereas TNF-int patients exhibited a dose-dependent trend. In contrast, TNF-high patients (approximately 13% of the total patients) had a clinical response to 10 mg/kg significantly better than the response to 3 and 6 mg/kg of infliximab. In TNF-high patients, the median trough serum levels of infliximab were below the detection limit (<0.1 μg/ml) at 3 and 6 mg/kg but were greater than 2 μg/ml at 10 mg/kg, whereas the levels were approximately 1 μg/ml for each dosage group in TNF-low patients. Conclusion: In patients with RA, baseline-TNF is significantly associated with the clinical response to infliximab in patients with a high baseline-TNF. A higher dose of infliximab may be necessary in these patients, whereas lower doses of infliximab are sufficient for those with a low baseline-TNF. Baseline-TNF may be a useful measure for personalising the treatment of RA using infliximab.
Rights: This article has been accepted for publication in Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infl iximab therapy in patients with rheumatoid arthritis, Tsutomu Takeuchi, Nobuyuki Miyasaka, Yoshihiko Tatsuki, Toshiro Yano, Toru Yoshinari, Tohru Abe and Takao Koike, Ann Rheum Dis, 2011, 70(7), pp.1208-1215, following peer review and can also be viewed on the journal's website at ard.bmj.com.
https://creativecommons.org/licenses/by-nc/3.0/
Type: article
URI: http://hdl.handle.net/2115/62831
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 小池 隆夫

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