[CIS PIDD] [cis-pidd] ADA2 deficiency - Infliximab dosage

Tue May 16 20:47:37 EDT 2017

We do the same on the adult IBD side

Sarah C. Glover, DO, AGAF
Director, Inflammatory Bowel and Celiac Disease Program
Associate Professor of Medicine
University of Florida
PO Box 103643 <x-apple-data-detectors://1>
Gainesville, FL 32610<x-apple-data-detectors://1>
http://gastroliver.medicine.ufl.edu/ibd/
Phone (UF Health patient access center): 352-273-9400<tel:352-273-9400>
Phone (IBD research): 352-265-8971<tel:352-265-8971>
Phone (Cell): 312-933-8039<tel:312-933-8039>
Fax 352-265-8979<tel:352-265-8979>

Sent from my iPhone

On May 16, 2017, at 2:10 PM, CIS-PIDD <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>> wrote:

Pediatric rheumatologists often use weekly subcutaneous injections of methotrexate to try to prevent the development of human anti-chimeric antibodies (HACA) to infliximab.  There is some data in adults that it is helpful.

Prescott

T. Prescott Atkinson, MD PhD, Professor and Director
Division of Pediatric Allergy, Asthma & Immunology
University of Alabama at Birmingham
Tel: 205-638-6457
Fax: 205-975-7080
Cell: 205-999-7688

From: cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net> [mailto:cis-pidd at lyris.dundee.net] On Behalf Of CIS-PIDD
Sent: Tuesday, May 16, 2017 10:11 AM
To: CIS-PIDD <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Subject: Re: [cis-pidd] ADA2 deficiency - Infliximab dosage

That is the standard IBD load.  I suggest you do proactive therapeutic drug monitoring after the load is complete to adjust the dosing.  Check level no sooner than 4 weeks after the third dose.  Ideally a true trough is helpful so 6 weeks after third dose would be best. Infliximab is more antigenic (up to 25 percent can develop anti drug antibodies) than other anti TNFs so  I typically premedicate with Tylenol, Benadryl, and IV hydrocortisone.

Infliximab level testing is available from labcorp, ARUP, Prometheus, Mayo lab, and Miraca for those of us in the US.

Levels can be impacted by extends of disease, albumin, and degree of inflammation.

Best,

SG
Sarah C. Glover, DO, AGAF
Director, Inflammatory Bowel and Celiac Disease Program
Associate Professor of Medicine
University of Florida
PO Box 103643 <x-apple-data-detectors://1>
Gainesville, FL 32610<x-apple-data-detectors://1>
http://gastroliver.medicine.ufl.edu/ibd/
Phone (UF Health patient access center): 352-273-9400<tel:352-273-9400>
Phone (IBD research): 352-265-8971<tel:352-265-8971>
Phone (Cell): 312-933-8039<tel:312-933-8039>
Fax 352-265-8979<tel:352-265-8979>

Sent from my iPhone

On May 16, 2017, at 11:00 AM, CIS-PIDD <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>> wrote:
Dear all,

I am planning to treat an ADA2 deficient patient with Infliximab and would like to know the dosage and the dosing intervall already used sucessfully.
Is it 5mg/kg at week 0, 2, 6 and thereafter every 8 weeks?

Thank you and best regards,

Fabian

Fabian Hauck, MD, PhD

Head Immunodeficiency Unit and Immunological Diagnostics Laboratoy
Pediatrics / Pediatric Hematology and Oncology / Immunology (DGfI)

Dr. von Hauner Children’s Hospital
Klinikum der Universität München
Lindwurmstr. 4, 80337 München
Germany

Tel.: +49 89 4400-53931
Fax: +49 89 4400-53964
E-Mail: fabian.hauck at med.uni-muenchen.de<mailto:fabian.hauck at med.uni-muenchen.de>

www.klinikum.uni-muenchen.de<http://www.klinikum.uni-muenchen.de/>

<image001.png>

Das Klinikum der Universität München ist eine Anstalt des öffentlichen Rechts (AöR)
The Klinikum der Universität München is an Institution under Public Law

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