炎症性肠病患者英夫利西单抗个体化治疗的研究进展

Research progress on personalized medicine of infliximab in patients with inflammatory bowel disease

英夫利西单抗(IFX)是首个被批准用于治疗炎症性肠病(IBD)的单克隆抗体,对IBD患者的诱导和维持治疗均有较好疗效,但临床仍有部分患者疗效欠佳甚至失应答。IFX体内药动学受抗IFX抗体(ATI)、疾病炎症反应程度、遗传等多方面因素的影响,可使其血药谷浓度(IFX-TLs)降低。IBD患者体内IFX-TLs和ATI与临床疗效具有一定相关性,可以作为预测IFX临床疗效的有效性指标。通过对IFX进行治疗药物监测(TDM)及个体化给药能够提高治疗效果及减少失应答的发生,且从经济学角度考虑,与常规疗法相比更具有成本效益。

Infliximab(IFX) is the first monoclonal antibody approved for the treatment of inflammatory bowel disease(IBD). It has been confirmed to be effective for both induction and maintenance therapy in patients with IBD,however,there are some patients with poor efficacy or even loss of response. The pharmacokinetics of IFX is affected by many factors such as anti-IFX antibody(ATI), the degree of disease inflammation and genetics, which can significantly reduce the blood trough concentration of IFX(IFX-TLs). IFX-TLs and ATI in patients with IBD have a certain correlation with its clinical efficacy, which can be used as effective indicators to predict the clinical efficacy of IFX. Therapeutic drug monitoring(TDM) and personalized medicine of IFX can help to improve its effectiveness and reduce the occurrence of non-response.Compared with the conventional therapy, TDM-based treatment is more cost-effective from an economic perspective.