Real-World Impact of Infliximab Precision-Guided Dosing on Management of Patients With IBD

Bincy P. Abraham, David A. Ziring, Thierry Dervieux, Patricia Aragon Han, Andrew Shim, Robert Battat

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


OBJECTIVES: Evaluate the clinical utility of a precision-guided dosing test for infliximab (IFX) and its impact on treatment decision-making for inflammatory bowel disease (IBD). STUDY DESIGN: Prospective, multisite, clinical experience program. METHODS: Health care providers were given access to PredictrPK IFX, a precision-guided dosing test, for their patients with IBD on maintenance IFX therapy. Blood samples were drawn 20 to 56 days post infusion. A Bayesian data assimilation tool used clinical and serologic data to generate individual pharmacokinetic profiles and forecast trough IFX. Results were reported to providers to aid in-therapy management decisions and the decision-making process was assessed through questionnaires. Relationships between forecasted IFX concentration, disease activity, and therapy management decisions were analyzed by logistic regression. RESULTS: PredictrPK IFX was used for 275 patients with IBD by 37 providers. In 58% of cases, providers modified treatment plans based on the results, including dose modifications (41%; of these, one-third decreased dose) and discontinuation (8%) of IFX. Of the 42% where treatment was not modified, 97.5% had IFX levels of 5 µg/mL or greater. Patients with IFX concentrations less than 5 µg/mL were 3 and 7.3 times more likely to have active disease or discontinue IFX, respectively. There was unanimous agreement among providers who completed a postprogram survey that PredictrPK IFX was beneficial in guiding treatment decisions and added more value to their practice than routine therapeutic drug monitoring. CONCLUSIONS: PredictrPK IFX enables earlier and more precise dose optimization of IFX in patients with IBD, exerting a substantial impact on treatment decisions that may result in improved health outcomes and overall cost savings.

Original languageEnglish (US)
Pages (from-to)S227-S235
JournalAmerican Journal of Managed Care
Issue number12 Suppl
StatePublished - Oct 2023


  • Humans
  • Infliximab/therapeutic use
  • Gastrointestinal Agents/therapeutic use
  • Prospective Studies
  • Bayes Theorem
  • Inflammatory Bowel Diseases/drug therapy
  • Drug Monitoring/methods

ASJC Scopus subject areas

  • Health Policy


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