Skip to Main content Skip to Navigation
Master Thesis

L'obésité, et plus particulièrement l’augmentation de la masse grasse sont-elles associées à des taux sériques d’Infliximab bas dans les rhumatismes inflammatoires chroniques ?

Abstract : Background : obesity is associated with a lower clinical response to TNF inhibitors in rheumatic diseases. This fact is also true for Infliximab (IFX), whereas the dosage is adapted to weight. It was demonstrate that trough serum infliximab (TSI) are negatively correlate with therapeutic response. We examined the relationship between obesity, more particularly body fat percentage (%BF) and TSI. Then, we examined on the one hand variables influenced by %BF and obesity, and on the other hand variables influencing TSI. Materiel and methods : in an observational-monocentric and cross-sectional study, we included consecutive patients treated by IFX for 2 months and more. We collected BMI and %BF from dual-energy X-ray absorptiometry. Serum samples were collected for assay of TSI and anti-IFX antibody (TSI) titer by ELISA. Results : 115 patients were included between August 2014 and March 2015 (18 RA and 92 SpA). Neither %BF nor BMI were associated with low levels of TSI. Median TSI was 2.79 [1.67; 8.43] among non-obese vs 3.56 [1.90; 9.17] µg/mL among obese subjects (p=0.41). We found a positive correlation between %BF and BASDAI (r=0.435 [0.088; 0.687], p=0.003) as well as ASDAS-CRP (r=0,294 [0,023; 0,525] p=0.017). TSI were positively correlated with IFX dosage (r=0.340 [0.162; 0.496], p < 10-3), negatively correlated with infusion spacing (r=-0.536 [-0.685; -0.387], p < 10-3), in particular after 6 weeks (10.24 [4.47-14.68] vs 2.67 [1.86-5.05] at 8 weeks and 1.30 [0.75-2.30] µg/mL at 10 weeks and more) and with the 3 mg/Kg dose (2.06 [0.99-4.48] vs 3.67 [2.05-10.22] at 5mg/Kg and 5.38 [3.91-19.04] µg/mL at 7.5mg/Kg)), and negatively correlated with the presence of ATI, (median TSI of ATI + 0 [0.006-0.055] vs 3.495 [1.959-9.207] µg/mL for ATI -, p < 10-4). Conclusion : TSI changes with IFX dose, spacing interval between 2 infusions and ATI +. %BF hasn’t negatively influence on TSI thanks to the dosage weight adaptation.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [86 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-01511955
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, April 21, 2017 - 6:11:39 PM
Last modification on : Wednesday, August 23, 2017 - 4:41:50 PM
Long-term archiving on: : Saturday, July 22, 2017 - 2:52:35 PM

Identifiers

  • HAL Id : dumas-01511955, version 1

Collections

Citation

Lorraine Bourdy-Hiebel. L'obésité, et plus particulièrement l’augmentation de la masse grasse sont-elles associées à des taux sériques d’Infliximab bas dans les rhumatismes inflammatoires chroniques ?. Médecine humaine et pathologie. 2017. ⟨dumas-01511955⟩

Share

Metrics

Record views

111

Files downloads

12