Use Blood Tests to Manage Loss of Response to Infliximab

Patients with inflammatory bowel disease who are treated with infliximab and lose their response in a clinical setting are often managed with a dose increase (from 5 mg/kg to 10 mg/kg), a shortened interval between doses, or both. Recently, it has become possible to measure serum infliximab levels and anti-infliximab antibodies (ATI). The use of these tests has been endorsed to determine whether the infliximab dose should be adjusted or the patient switched to alternative therapies. Now, investigators compare the cost-effectiveness of this testing strategy with empiric dose adjustment.

In the decision analytic model used in this study, the testing strategy involves switching to a different tumor necrosis factor antagonist in the presence of …