About My Health Careers Internship MedBlogs Contact us

Monitor Medication in inflammatory bowel disease To Improve Outcomes

by Hannah Joy on October 4, 2017 at 2:40 PM
Font : A-A+

Monitor Medication in inflammatory bowel disease To Improve Outcomes

Patients with inflammatory bowel disease (IBD) need to be closely monitored by doctors when being treated with infliximab before they lose efficacy towards the drug. When doctors monitor medications of patients with IBD can lead to better long-term outcomes, reveals a new study.

In patients with inflammatory bowel disease (IBD), the body attacks the lining of the digestive tract. Up to half of patients who benefit from the first-line anti-inflammatory drug infliximab eventually stop responding to it. When that happens, doctors may begin to monitor patients' blood serum concentrations of the drug.


The team was led by gastroenterologists at the Center for Inflammatory Bowel Diseases at Beth Israel Deaconess Medical Center (BIDMC) and University of Pennsylvania.

The team's retrospective study could set the stage for a change in the standard clinical approach to IBD. Their data were published in the October issue of the journal Clinical Gastroenterology and Hepatology.

"IBD can lead to serious complications and a high rate of surgery despite medical therapy," said Adam S. Cheifetz, MD, Director of the Center for Inflammatory Bowel Disease who is also an Associate Professor of Medicine at Harvard Medical School.

"We demonstrated that proactive drug monitoring is associated with better clinical outcomes, including less treatment failure, serious infusion reactions, and less need for IBD-related surgery or hospitalization, when compared to reactive drug monitoring."

A chronic, life-long condition that can manifest as severe pain, diarrhea, lack of energy, rectal bleeding and weight loss, IBD which includes Crohn's disease and ulcerative colitis affects over 1.5 million Americans.

Infliximab reduces symptoms and inflammation by targeting one of the proteins called tumor necrosis factor (TNF) that leads to inflammation in IBD.

Eventually, about half the patients who take the drug stop responding to it but not all for the same reasons. Some patients eventually develop antibodies against infliximab and need to switch medications. Previous research by Cheifetz and others suggested that monitoring drug levels prior to loss of efficacy could improve treatment outcomes.

For this multicenter retrospective study, Cheifetz and colleagues analyzed the long-term outcomes of 264 patients with IBD on infliximab maintenance at either BIDMC or University of Pennsylvania hospitals, just under half of whom were monitored proactively.

Of those, only 13 percent of patients experienced a treatment failure defined as loss of response to infliximab or need for IBD-related surgery. In contrast, two-thirds a full 66 percent of the 134 patients undergoing reactive drug monitoring experienced treatment failure.

In addition, the probability and length of a hospital stay was much lower among patients being proactively monitored. Just seven percent of these patients had IBD-related hospitalizations, compared to a quarter of patients undergoing reactive monitoring. The total hospital stay was also much shorter among the proactively monitored patients; 37 days compared to 189 days for the reactive group.

"Prolonging infliximab's efficacy and avoiding surgery and hospitalization is very important for patients with IBD," said Cheifetz.

"Proactive monitoring is the standard of care in my practice and that of [co-senior author] Mark Osterman, MD, and I think it would benefit the vast majority of patients on infliximab and similar biologic medications."

To follow up, Cheifetz and his colleagues will conduct a similar analysis comparing outcomes for reactive versus proactive monitoring of another drug used in the treatment of IBD, adalimumab.

"Large, prospective studies are needed to confirm these results," he said.

Source: Eurekalert

News A-Z
News Category
What's New on Medindia
Goji Berries May Protect Against Age-Related Vision Loss
Tapping — A Proven Self-Applied Stress Intervention
Black Pepper as Preventive Measure Against Omicron
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Drug Toxicity Colo-rectal cancer - Management Crohns Disease Healthy Living Inflammatory Bowel Disease Foul Smelling Stool 

Recommended Reading
Role of Infliximab in Treating Kawasaki Disease Evaluated in Study
Kawasaki Disease (KD) is often mistaken for an inconsequential viral infection....
Resuming Infliximab Therapy After Stopping It can be ‘Very Beneficial’ for IBD Patients
A new study suggests that patients suffering from inflammatory bowel disease may benefit by ......
Biological Agents may Help Offset Recurrence of Crohn's Disease
Two new studies have discovered that biological agents may help offset the recurrence of Crohn's ......
Combination of Biologics With Traditional Therapy Beneficial in Psoriasis
Combination of biologics with traditional therapy has been found to be beneficial in Psoriasis ......
Colo-rectal cancer - Management
Treatment for Colorectal Cancers may involve surgery,chemotherapy, radiation therapy or biological t...
Crohns Disease
Crohn’s disease or regional enteritis is an inflammatory bowel disease that involves the small intes...
Drug Toxicity
Drug toxicity is an adverse reaction of the body towards a drug that results as a side effect of a d...
Foul Smelling Stool
Foul smelling stool is a stool that has a bad odor. Poor diet and indigestion are the most common ca...
Inflammatory Bowel Disease
Inflammatory bowel disease involves chronic inflammation of the colon and small intestine. Symptoms ...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2022

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use
open close
I have read and I do accept terms of use - Telemedicine

Advantage Medindia: FREE subscription for 'Personalised Health & Wellness website with consultation' (Value Rs.300/-)