P424 Association between infliximab trough levels, clinical remission, mucosal healing and quality of life in patients with inflammatory bowel disease on maintenance therapy

Abstract

Background: Adequate infliximab (IFX) trough levels (TL) are asso-ciated with clinical remission (CR) and mucosal healing (MH). We aimed to investigate the association between ITX TL and quality of life (QoL) in inflammatory bowel disease (IBD) patients. Methods: We carried out a prospective cohort study in IBD patients in IFX maintenance therapy. IFX levels were determined using a quantitative rapid test immediately before drug infusion. Disease activity indices (MAYO/HBI), endoscopic scores (MAYO/SES-CD) were obtained. QoL was assessed using the Inflammatory Bowel Disease Questionnaire (IBDq). The study was approved by the Institutional Review Board and informed consent was obtained from all patients. Results: Seventy-one consecutive subjects were included in the study (59 with Crohn's disease and 17 with ulcerative colitis). Drug levels were considered satisfactory (TL>=3mug/mL) in 29 patients (39.4%) and unsatisfactory (TL<3mug/mL) in 43 (60.6%). Satisfactory TL were associated with higher rates of clinical remission (85.7% x 27.9%, p<0.001) and mucosal healing (85.7% x 18.6%, p<0.001). Higher TL were also associated with improved IBDQ scores (183+/-32 x 161+/-28, p=0.006), particularly regarding bowel symptoms (59.6+/-9.3 x 52.3+/-8.5, p=0.001), systemic function (27.3+/-5.6 x 22.7+/-5.2, p=0.001) and social function (30.8+/-5.7 x 26.7+/-7.4, p=0.015). Conclusions: Satisfactory IFX levels were associated with higher rates of CR, MH and improved QoL in IBD patients on maintenance therapy.