Early Inflammatory Markers are Associated With Inadequate Po
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In paediatric Crohn's disease, infliximab trough concentrations after standard weight-based induction therapy are usually below 7 g/mL. Clinical patient results are correlated with post-induction infliximab trough concentration. Markers of inflammation are associated with low infliximab concentrations during maintenance dosing. Researchers tried to determine whether early indicators of disease development are associated with insufficient post-induction infliximab trough concentrations in paediatric Crohn's disease.

A retrospective single-center case-control study of pediatric Crohn's disease patients was performed to assess the association between baseline and week-2 biomarkers (albumin, C-reactive protein, and erythrocyte sedimentation rate) and inadequate post-induction infliximab trough concentration (less than 7 g/mL) in patients treated with standard 5 mg/kg dosing. Baseline and week-2 biomarker values were coded as dichotomous variables at clinically useful thresholds. Univariable logistic regression was used to calculate odds ratios of developing an inadequate infliximab trough concentration for each threshold, as well as thresholds in combination. 55 patients were evaluated

Results:
--Early biomarker thresholds significantly associated with inadequate post-induction infliximab trough concentrations included:
-Baseline C-reactive protein more than 1 mg/dL (odds ratio [OR] 4.58),
-Both baseline C-reactive protein more than 0.5 mg/dL and albumin less than 3.5 g/dL (OR 8.31), and
-Week-2 C-reactive protein more than 0.5 mg/dL or albumin less than 3.5 mg/dL or erythrocyte sedimentation rate more than 25 mm/hour (OR 11.08).

Conclusively, regular baseline and week-2 markers of disease activity at clinically useful thresholds were correlated with insufficient post-induction infliximab trough concentration in paediatric Crohn's disease patients undergoing normal weight-based induction dosing.

Source: https://journals.lww.com/jpgn/Abstract/2021/03000/Early_Inflammatory_Markers_are_Associated_With.15.aspx
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