Association Between Infliximab Trough Levels and the Occurrence of Paradoxical Manifestations in Patients with Inflammatory Bowel Disease: a Case-Control Study.

摘要: Background and Aim: Anti-tumour necrosis factor [TNF] agents have dramatically improved the prognosis of inflammatory bowel disease [IBD]. However, despite their good safety profile, use these may lead to paradoxical manifestations involving skin or joints. Pathogenesis such side effects is poorly understood involve anti-TNF pharmacokinetics. The aim present study was look for an association between infliximab trough levels [ITL] cutaneous [CPM] rheumatological [RPM] manifestations. Methods: IBD patients receiving as maintenance therapy were included in a cross-sectional prospective monocentre study. At inclusion, had ITL measurement [LISA-TRACKER®, Biomedical Diagnostics BMD] assessed manifestations: CPM defined by new onset exacerbation pre-existing psoriasis lesions during IFX therapy, RPM severe poly-arthralgia therapy. Results: Among 121 [69 female; median age: 38.9 years; 92 with Crohn’s disease], 7% 8% RPM. Median values 5.87 [range: 0.52–19.53] µg/ml 1.90 [0.00–13.5] those RPM, compared respectively 5.12 [0.00–49.12] without [ p = 0.56] 5.57 0.058]. No prognostic associated CPM. single elevated antinuclear antibodies. Conclusion: not developing when therapy. As suggested high level antibodies, could be related induced autoimmune disorder.