Relationship between inflammation and infliximab pharmacokinetics in rheumatoid arthritis.

ABSTRACT: Infliximab, an anti-tumour necrosis factor-? monoclonal antibody, is indicated in rheumatoid arthritis (RA). Our objective was to evaluate the influence of the sources of infliximab pharmacokinetic variability in RA.Eighty-four patients treated with infliximab for RA were included in a prospective noncomparative study. They were analysed between two consecutive infliximab infusions. Infliximab concentrations were measured before the infusion, 2?h, 1 and 4 weeks after the infusion and immediately before the next infusion. Infliximab concentrations were described using a two-compartment population pharmacokinetic model.The mean (interindividual standard deviation) estimated central volume of distribution was 2.3?l (36%) and systemic clearance was 0.019?l?h(-1) (37%). The central volume of distribution increased with bodyweight; it was doubled between 50 and 90?kg. Systemic clearance increased with pre-infusion C-reactive protein concentration by 20%, varying from 3 to 14?mg?l(-) 1, and was decreased by 30% when methotrexate was coadministered.The influence of methotrexate and inflammation on infliximab clearance suggests that individual adjustment of infliximab doses according to disease activity may be useful in RA.

SUBMITTER: Ternant D 

PROVIDER: S-EPMC4168386 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature