Infliximab levels

[Eire]

Hi everyone.
Im a 50 year old female on infliximab for Crohns since Sept 2022.
My bloods taken on jan 5th show remicade level at 8.3. Antibodies also detected. My gastroenterologist says the drug level should be higher and she wants to see me in a few weeks.
Should I be worried? What are the acceptable drug levels?
I am symptom free.
Many thanks.
Mairead

 

[Scipio]

Many GIs like to see Remicade levels in the 5 to 10 range. Some prefer higher. So an 8.3 is normally a solid number, but perhaps your doc is one of those who likes the numbers to be a bit higher, and/or perhaps the antibody level is a bit worrying, thus the need to to boost the Remicade a bit to be sure to overpower the drug inactivating effects of the antibodies and keep you symptom free.

 

[Eire]

Thanks for your reply Scipio. Its reassuring.
I dont know what GI has planned for me. Hopefully leave me on remicade. I wouldnt like to have to switch meds after only 6 months. Im just so glad to be symptom free apart from mild cramps sometimes.
Last year was difficult. 2 hospital stays due to fistulising infections.
all will be well

 

[Eire]

Hi everyone
Met my GI during the week. My ADA level is 86. Is this high? (Why didnt I ask her?!.... )
Im going to have an IV boost of remicade and start taking an immunosuppressant tablet. ( cant remember the name....starts with P).
Also possible surgery on anal fistula which has never healed fully since initial surgery july 22.
Really dont like the idea of that.
Good news is im continuing to be symptom free on Remicade.

 

[Scipio]

Hi everyone
Met my GI during the week. My ADA level is 86. Is this high? (Why didnt I ask her?!.... )
Im going to have an IV boost of remicade and start taking an immunosuppressant tablet. ( cant remember the name....starts with P).
Also possible surgery on anal fistula which has never healed fully since initial surgery july 22.
Really dont like the idea of that.
Good news is im continuing to be symptom free on Remicade.

86 is quite high for anti-drug antibodies against Remicade. It varies from one type of test to another, but generally numbers higher than 10 are considered positive.

I'm guessing the immunosuppressant you are getting is probably mercaptopurine, also known as 6-MP. Several of its brand names start with a P.