30 likes | 137 Views
Aclinical Utility of measuring [IFX] & HACA in Pts with IBD. Afif w, et al. Am J Gastroenterol . 2010;105:1133-1139. Results for IBD Pt with IFX Loss of Response. Response rate 92%. ∆ Anti-TNF α. HACA (+). ↑ IFX dose or Freq. Response rate 17 %. Active IBD Endo/Rad 38%.
E N D
Aclinical Utility of measuring [IFX] & HACA in Pts with IBD Afif w, et al. Am J Gastroenterol. 2010;105:1133-1139
Results for IBD Pt with IFX Loss of Response Response rate 92% ∆ Anti-TNFα HACA (+) ↑ IFX dose or Freq Response rate 17 % Active IBD Endo/Rad 38% Failure, ∆ Rx different mechanism Therapeutic [IFX] > 12 mcg/ml @ 4wk Inactive IBD Endo/Rad 62% of pts Investigate alternative etiology SubTherapeutic [IFX] < 12 mcg/ml @ 4wk ↑ IFX dose or Freq Response rate 86 % ∆ Anti-TNFα Response rate 33 % P R McNally, DO, FACP, FACG
Algorithm for IBD Pt with IFX Loss of Response Failure, ∆ Rx different mechanism HACA (+) ∆ Anti-TNFα Failure, ∆ Rx different mechanism Active IBD Endo/Rad Therapeutic [IFX] > 12 mcg/ml @ 4wk Inactive IBD Endo/Rad Investigate alternative etiology ∆ Anti-TNFα ↑ IFX dose or Freq SubTherapeutic [IFX] < 12 mcg/ml @ 4wk Failure, ∆ Rx different mechanism ∆ Anti-TNFα P R McNally, DO, FACP, FACG