open access

https://hdl.handle.net/2115/62831

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

英語

2011-07

BMJ Publishing Group

Annals of the Rheumatic Diseases

70(7)

1208-1215

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.

学術雑誌論文

Version of Record

Creative Commons Attribution-NonCommercial 3.0 Unported

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.

0003-4967

AA00533085