Evidence map›Paper›PMID 38374555›Full record

Observational studyJournal of pediatric gastroenterology and nutrition2024

Anti-infliximab antibodies and low infliximab levels correlate with drug discontinuation in pediatric inflammatory bowel disease.

Naamah Zitomersky, Lisa Chi, Enju Liu, Kurtis R Bray, Konstantinos Papamichael, Adam S Cheifetz, Scott B Snapper, Athos Bousvaros, Jocelyn A Silvester

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Journal of pediatric gastroenterology and nutrition, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Guideline
  2. Observational
  3. Review
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Naamah ZitomerskyDepartment of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
Lisa ChiDepartment of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
Enju LiuInstitutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, USA.
Kurtis R BrayPrometheus Laboratories Inc, San Diego, California, USA.
Konstantinos PapamichaelHarvard Medical School, Boston, Massachusetts, USA.
Adam S CheifetzHarvard Medical School, Boston, Massachusetts, USA.
Scott B SnapperDepartment of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
Athos BousvarosDepartment of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
Jocelyn A SilvesterDepartment of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
Boston Children's Hospital · USHarvard University · USBeth Israel Deaconess Medical Center · USPrometheus Biosciences (United States) · US

Funding

STRUCTURE-FUNCTION RELATIONSHIPS IN THE ALIMENTARY TRACTP30DK034854 · NIDDK · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI LYNN BRY · 1986 to 2026
$32.4M
RESEARCH TRAINING IN GASTROENTEROLOGYT32DK007760 · NIDDK · BETH ISRAEL DEACONESS MEDICAL CENTER · PI KELLY, CIARAN P · 1999 to 2019
$4.6M
Mechanisms and Markers of Small Intestinal Epithelial Injury and Villous AtrophyK23DK119584 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI SILVESTER, JOCELYN ANNE · 2019 to 2023
$971k
NIDDK NIH HHS K23 DK119584NIDDK NIH HHS P30 DK034854NIDDK NIH HHS T32 DK007760
6 · The paper itself

Abstract

backgroundInfliximab (IFX) use is limited by loss of response often due to the development of anti-IFX antibodies and low drug levels.

methodsWe performed a single center prospective observational cohort study of pediatric and young adult subjects with inflammatory bowel disease (IBD) on IFX with over 3 years of follow-up. Infliximab levels (IFXL) and antibodies to infliximab (ATI) were measured throughout the study. Subjects were followed until IFX was discontinued.

resultsWe enrolled 219 subjects with IBD (184: Crohn's disease; 33: Ulcerative colitis; and 2 Indeterminant colitis; 84 female, median age 14.4 years, 37% on concomitant immunomodulator). Nine hundred and nineteen serum samples (mean 4.2 ± 2.1 per patient) were tested for IFXL and ATI. During the study, 31 (14%) subjects discontinued IFX. Sixty patients had ATI. Twenty-two of those 60 patients with ATI discontinued IFX; 14 of 31 patients who discontinued IFX had detectable ATI at study onset. The combination of ATI and IFXL < 5 µg/mL at study entry was associated with the highest risk of drug discontinuation (hazard ratios [HR] ATI 4.27 [p < 0.001] and IFXL < 5 µg/mL [HR]: 3.2 p = 0.001). Patients with IFXL 5-10 µg/mL had the lowest rate of discontinuation (6%). IFX dose escalation eliminated ATI in 21 of 60 subjects.

conclusionsATI is a strong predictor of needing to stop IFX use and inversely correlates with IFXL. Detection of ATI during therapeutic drug monitoring postinduction but also periodically during maintenance therapy identifies individuals who may benefit from IFX dose escalation and/or the addition of an immunomodulator, as these interventions may reduce or eliminate ATI.

Indexed as

Colitis, UlcerativeCrohn DiseaseInflammatory Bowel DiseasesAdolescentAntibodiesChildDrug MonitoringFemaleGastrointestinal AgentsHumansImmunologic FactorsInfliximabProspective StudiesYoung AdultAntibodiesGastrointestinal AgentsImmunologic FactorsInfliximabantibodies to infliximabCrohn's diseaseinfliximab levelpediatric inflammatory bowel diseaseulcerative colitis

Identifiers

PMID38374555
PMCPMC10883602
OpenAlexW4390268712

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.