Comparison of three immunoassays for infliximab trough level monitoring in paediatric inflammatory bowel diseases

Biologicals. 2021 Apr:70:17-21. doi: 10.1016/j.biologicals.2021.02.002. Epub 2021 Mar 3.

Abstract

Many clinical studies in paediatric inflammatory bowel diseases (IBD) use infliximab trough level (IFX-TL) and detection of antibody against infliximab (ATI). Hence, comparison of commercially available assays is needed in paediatric samples to assess their reliability and their comparability. We measured IFX-TL and ATI-TL in sera samples of 53 IBD children using three ELISA kits: Lisa-Tracker® Duo Infliximab (Theradiag®), Ridascreen® IFX monitoring (R-Biopharm®) and Promonitor® IFX (Grifols®). Regarding IFX-TL, median values were comparable (p > 0.05), a good statistical correlation has been observed (0.73 ≤ R2 ≤ 0.85) between tested assays and the Bland-Altman analysis found an excellent agreement with a bias estimated between -0.56 and 0.12 and few values outside the 95% limits of agreement. However, qualitative comparison with therapeutic interval classifications showed some discrepancies (30.2%), mainly due to values near thresholds and more often than not with Theradiag® (22.6%). For ATI, because of non-standardized units, the qualitative comparison found a sensibly good agreement (98.1%). These data show a good agreement of IFX-TL and ATI measurement between three marketed ELISA assays with a small bias obtained. Variations in some results can lead to divergent therapeutic interval classifications and prompt us to be cautious in the interpretation of values near therapeutic thresholds.

Keywords: Anti-infliximab antibodies; Immunomonitoring; Inflammatory bowel disease; Infliximab; Paediatric therapeutics.

Publication types

  • Comparative Study

MeSH terms

  • Antibodies
  • Child
  • Drug Monitoring*
  • Enzyme-Linked Immunosorbent Assay / methods*
  • Gastrointestinal Agents / pharmacokinetics
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Inflammatory Bowel Diseases* / drug therapy
  • Infliximab / pharmacokinetics*
  • Infliximab / therapeutic use
  • Reproducibility of Results

Substances

  • Antibodies
  • Gastrointestinal Agents
  • Infliximab