RESUMEN
OBJECTIVES: In Latin America, experience with monitoring serum Infliximab (IFX) concentrations is scarce. Our study aimed to compare IFX serum concentrations between patients with active disease or in remission. PATIENTS AND METHODS: A cross-sectional study was performed in patients with luminal Crohn's disease (CD) during maintenance treatment with IFX. Patients were classified as in remission or disease activity according to clinical scores and endoscopic, radiological, and laboratory markers. A comparison of IFX trough levels between the two groups was performed. RESULTS: 80 CD patients were included [41 (51%) in remission and 39 (49%) with active disease]. In the analysis of general disease activity, the median serum levels of IFX in patients with remission and with active CD were 5.63 [0.03-14.40] vs. 3.84 [0.03-14.40] (p=0.287). Furthermore, there was no difference in serum IFX concentrations in endoscopic, radiological, and laboratory activities. Only in the clinical evaluation there was a significant difference in the median serum IFX levels between patients in remission and disease activity, 5.63 [0.03-14.40] vs. 2.14 [0.32-10.54] (p=0.042). CONCLUSIONS: IFX serum concentrations during maintenance treatment were similar in patients with luminal CD in remission and general, endoscopic, radiological, and laboratory disease activity. Patients with clinically active disease had lower IFX concentrations than patients in remission.
Asunto(s)
Enfermedad de Crohn , Fármacos Gastrointestinales , Infliximab , Humanos , Enfermedad de Crohn/tratamiento farmacológico , Enfermedad de Crohn/sangre , Infliximab/sangre , Infliximab/uso terapéutico , Infliximab/farmacocinética , Estudios Transversales , Masculino , Femenino , Adulto , Fármacos Gastrointestinales/sangre , Fármacos Gastrointestinales/uso terapéutico , Fármacos Gastrointestinales/farmacocinética , Inducción de Remisión , Adulto Joven , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Monitoreo de DrogasRESUMEN
A leucemia representa numericamente cerca de 3% de todos os tipos de câncer. As leucemias agudas têm como principal característica o acúmulo de células jovens (blásticas) anormais na medula óssea, que substituem as células sanguíneas normais. No presente estudo, durante o período de julho de 2009 a julho de 2011, analisaram-se 29 prontuários de pacientes com leucemias agudas, internados no Hospital Universitário Evangélico de Curitiba. Avaliaram-se os seguintes dados nos prontuários: sexo, idade, cor, profissão, queixa principal, data do diagnóstico, classificação da leucemia, hemograma de admissão e de saída, mielograma, protocolo de quimioterapia, complicações, antibioticoterapia, óbito e causa mortis. Encontrou-se uma prevalência de 75,9% (n=22) casos de LMA (leucemia mieloide aguda) sobre 24,1% (n=7) casos de LLA (leucemia mieloide aguda). A idade média encontrada foi 39,7 anos. Houve uma predominância de pacientes do sexo feminino e brancos. A queixa principal encontrada com maior frequência foi astenia/fraqueza (51,7%). Foram detectados blastos no sangue periférico de 58,6% dos pacientes no momento da admissão. A taxa de mortalidade correspondeu a 51,7%, sendo choque séptico a causa mais comum
Leukemia is numerically about 3% of all cancers. The acute leukemia has as main characteristic the accumulation of immature white blood cells (blast) abnormal bone marrow, replacing normal blood cells. During the period of July 2009 to July 2011 there were analyzed medical records of 29 patients with acute leukemia admitted in a University Hospital in Curitiba. We evaluated the following information on the medical records: sex, age, race, profession, chief complaint, date of diagnosis, classification of leukemia, blood counts of entry and exit, bone marrow, chemotherapy protocol, complications, antibiotic therapy, death and cause of death. We found a prevalence of 75.9% (n = 22) cases of AML, over 24.1% (n = 7) cases of ALL. Mean age was 39.7 years. There was a predominance of females and white race. The chief complaint found more frequently was asthenia / weakness (51.7%). Blasts were detected in peripheral blood of 58.6% of patients on admission. The mortality rate amounted to 51.7%, and septic shock was the most common cause.