Measurement of infliximab drug and antibody levels to help improve management

What is it about?

Personalised medicine tailors treatment to the individual's needs. The advent of biosimilars has led to therapy re-appraisals driven by the clinical commissioning group's demand for cost-effective interventions. Yet biologic drug dosing is standardised and little is known about the rationale and efficacy of dose adjustment. As part of a service evaluation exercise within the Leeds Spondyloarthritis (SpA) Service, we measured serum drug trough levels (DLs) and anti-drug antibodies (ADAbs) in our cohort of SpA patients receiving bio-originator infliximab (Remicade) with the aims of a) informing our decision making before a possible switch to biosimilar and b) assessing the possible impact of this approach to our clinical practice.

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Why is it important?

These data from a small cohort suggest that measuring ADAbs and DLs to characterise treatment response and inform biosimilar switching is a clinically efficacious and cost-effective strategy in infliximab-treated SpA patients. We anticipate further significant savings with our cohort receiving subcutaneous therapies. This approach unlocks the potential of ‘personalised medicine’ which supports individualised treatment and brings significant savings to the NHS