{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:42:58Z","timestamp":1772995378262,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":36,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100014554","name":"Janssen Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014554","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Although it is generally believed that infliximab dose optimization in patients with inflammatory bowel disease with low serum infliximab concentration at trough results in increased treatment persistence, empirical data to support this notion are lacking. This study evaluated the association of infliximab therapeutic drug monitoring (TDM) and TDM\u2010associated dose optimization with persistence in real\u2010world practice.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    Data from adults with Crohn\u2019s disease (CD) or ulcerative colitis (UC) who participated in a national patient support program (PSP) in Canada were analyzed. Participants who had a first TDM evaluation (with a recorded infliximab trough concentration) in the maintenance phase of treatment were assessed (excluding those who underwent prior dose optimization). Persistence was evaluated using time\u2010dependent Cox proportional hazards models.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    In the overall population of patients with CD or UC, TDM was not associated with longer persistence (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200913,203). In patients with no prior dose optimization (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092729) who had a serum infliximab concentration of &lt; 3\u2009\u03bcg\/mL, dose optimization within 9\u2009weeks of TDM was associated with significantly longer persistence (HR: 0.36; 95% CI: 0.26, 0.50 for CD [\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009711] and HR: 0.30, 95% CI: 0.21, 0.43 for UC [\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009501]). Sensitivity analyses yielded similar results when using a threshold concentration of &lt; 5\u2009\u03bcg\/mL. In an analysis excluding patients who received no further treatment after TDM, the association between dose optimization and longer persistence was not confirmed in patients with CD, and mostly confirmed in patients with UC at a threshold concentration of &lt; 3\u2009\u03bcg\/mL.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    TDM\u2010associated dose optimization in patients with UC with low serum infliximab concentrations was associated with longer persistence. This association was not confirmed in patients with CD. This study demonstrated that real\u2010world data from a PSP\u2010generated cohort can be evaluated to inform clinical practice and that this approach may be complementary to other types of cohort studies.\n                  <\/jats:p>","DOI":"10.1155\/cjgh\/5713315","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T05:03:31Z","timestamp":1738818211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Therapeutic Drug Monitoring for Dose Optimization of Infliximab in Patients With Inflammatory Bowel Disease: An Analysis of Canadian Real\u2010World Data"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7764-9527","authenticated-orcid":false,"given":"David C.","family":"Sealey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai Fai","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9511-1175","authenticated-orcid":false,"given":"Z. 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