Relationship between inflammation and infliximab pharmacokinetics in rheumatoid arthritis
David Ternant, Emilie Ducourau, Aleth Perdriger, Anca Corondan, Benoît Le Goff, Valérie Devauchelle-Pensec, Elisabeth Solau-Gervais, Hervé Watier, Philippe Goupille, Gilles Paintaud, Denis Mulleman, David Ternant, Emilie Ducourau, Aleth Perdriger, Anca Corondan, Benoît Le Goff, Valérie Devauchelle-Pensec, Elisabeth Solau-Gervais, Hervé Watier, Philippe Goupille, Gilles Paintaud, Denis Mulleman
Abstract
Aims: Infliximab, an anti-tumour necrosis factor-α monoclonal antibody, is indicated in rheumatoid arthritis (RA). Our objective was to evaluate the influence of the sources of infliximab pharmacokinetic variability in RA.
Methods: 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.
Results: 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.
Conclusions: 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.
Keywords: inflammation; infliximab; monoclonal antibodies; pharmacokinetics; rheumatoid arthritis.
© 2013 The British Pharmacological Society.
Figures
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4168386/bin/bcp0078-0118-f1.jpg)
![Figure 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4168386/bin/bcp0078-0118-f2.jpg)
![Figure 3](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4168386/bin/bcp0078-0118-f3.jpg)
![Figure 4](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4168386/bin/bcp0078-0118-f4.jpg)
![Figure 5](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4168386/bin/bcp0078-0118-f5.jpg)
Source: PubMed