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• W3096317393 abstract "Background The BSPGHAN and ESPGHAN 2018 standards on management of IBD advocate optimising the use of biological therapy by correlating infliximab drug and anti-body levels with clinical presentation, and subsequently altering treatment if sub-optimal. We aimed to evaluate the infliximab practice at the Royal Manchester Children’s Hospital (RMCH), United Kingdom against these recently published standards. Methods A retrospective study was performed on patients with IBD who had infliximab drug and antibodies levels measured between Oct-2017 and Oct-2018 at RMCH. We collected data on each patient’s current status including stage of disease, infliximab drug and antibody levels, and changes in management if taken. These results were divided into 3 categories for analysis according to infliximab levels: sub-therapeutic (≤4 ug/ml), medium therapeutic (4–7.9 ug/ml) and high therapeutic (≥8 ug/ml). These were then further divided into negative/low level antibodies (≤20 ug/ml) and high level antibodies (≥ 21 ug/ml) subgroups. Each data set was examined to check for adherence to standards. Results During this 13 month period, 77 patients in total had their infliximab levels checked. 72(94%) of these patients were on the recommended immunosuppressant therapy of azathioprine. Many of these patients had multiple infliximab levels performed during the period generating 136 infliximab levels. Out of the total 136 levels done, 87(64%) were sub-therapeutic. 71(82%) of patients with sub-therapeutic infliximab levels showed non active disease either confirmed with normal inflammatory markers or endoscopic findings suggestive of remission. For the 87 with sub-therapeutic Ievels, there were 59(68%) with negative/low antibodies, 35(60%) of these cases were then managed by increasing their infliximab dose/frequency as advised by the standards. For the remaining 28(32%) in the sub-therapeutic group who had positive antibodies, 25%(7) were switched onto a different biologic as recommended by the standards. However, despite having significant levels of antibodies, 14(50%) of patients in the sub-therapeutic group had their infliximab dose/frequency increased. Conclusions There is extensive variability in the infliximab practice for management of IBD at RMCH when comparing against the BSPGHAN/ESPGHAN standards due to being recently published, emphasising capacity for improvement." @default.
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• W3096317393 date "2020-10-01" @default.
• W3096317393 modified "2023-10-17" @default.
• W3096317393 title "G354(P) Experience of using anti-TNF infliximab in paediatric inflammatory bowel disease- single tertiary" @default.
• W3096317393 doi "https://doi.org/10.1136/archdischild-2020-rcpch.302" @default.
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