Abstract
Background
The following review is a compilation of the recent advances and knowledge on the behaviour of the most frequently used compounds to treat inflammatory bowel disease in an organism.
Results
It considers clinical aspects of each entity and the pharmacokinetic/pharmacodynamic relationship supported by the use of plasma monitoring, tissue concentrations, and certain aspects derived from pharmacogenetics.
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References
Ordas I, Feagan BG, Sandborn WG (2012) Therapeutic drug monitoring of tumor necrosis factor antagonists in inflammatory bowel disease. Clin Gastroenterol Hepatol 10:1079–1087
Schneider RE, Babb J, Bishop H, Mitchard M (1976) Plasma levels of propranolol in treated patients with coeliac disease and patients with Crohn’s disease. Br Med J 2:794–795
Kendall MJ, Quarterman CP, Bishop H, Schneider RE (1979) Effect of inflammatory disease on plasma oxprenolol concentrations. Br Med J 2:465–468
Scotto KW (2003) Transcriptional regulation of ABC drug transporters. Oncogene 22:7496–7511
Schinkel AH, Jonker JW (2003) Mammalian drug efflux transporters of the ATP binding cassette (ABC) family: an overview. Adv Drug Deliv Rev 55:3–29
Mikkaichi T, Suzuki T, Tanemoto M, Ito S, Abe T (2004) The organic anion transporter (OATP) family. Drug Metab Pharmacokinet 19:171–179
Kim RB (2003) Organic anion-transporting polypeptide (OATP) transporter family and drug disposition. Eur J Clin Invest 33(Suppl 2):1–5
Petrovic V, Teng S, Piquette-Miller M (2007) Regulation of drug transporters during infection and inflammation. Mol Interv 7:99–111
Slaviero KA, Clarke SJ, Rivory LP (2003) Inflammatory response: an unrecognized source of variability in the pharmacokinetics and pharmacodynamics of cancer chemotherapy. Lancet Oncol 4:224–232
Aitken AE, Richardson TA, Morgan ET (2006) Regulation of drug-metabolizing enzymes and transporters in inflammation. Annu Rev Pharmacol Toxicol 46:123–149
Renton KW (2005) Regulation of drug metabolism and disposition during inflammation and infection. Expert Opin Drug Metab Toxicol 1:629–640
Robertson GR, Liddle C, Clarke SJ (2008) Inflammation and altered drug clearance in cancer: transcriptional repression of a human CYP3A4 transgene in tumor-bearing mice. Clin Pharmacol Ther 83:894–897
Nolin TD, Naud J, Leblond FA, Pichette V (2008) The emerging impact of kidney disease on drug metabolism and transport. Clin Pharmacol Ther 83:898–903
Yacyshyn B, Maksymowych W, Bowen-Yacyshyn MB (1999) Differences in P-glycoprotein-170 expression and activity between Crohn’s disease and ulcerative colitis. Hum Immunol 60(8):677–687
Evans WE, McLeod HL (2003) Pharmacogenomics: drug disposition, drug targets, and side effects. N Engl J Med 348:538–549
Azad Khan AK, Piris J, Truelove SC (1977) An experiment to determine the active therapeutic moiety of sulphasalazine. Lancet 2:892–895
van Hees PA, Bakker JH, van Tongeren JH (1980) Effect of sulphapyridine, 5-aminosalicylic acid, and placebo in patients with idiopathic proctitis: a study to determine the active therapeutic moiety of sulphasalazine. Gut 21:632–635
Klotz U, Maier K, Fischer C, Heinkel K (1980) Therapeutic efficacy of sulfasalazine and its metabolites in patients with ulcerative colitis and Crohn’s disease. N Engl J Med 303:1499–1502
Dignass A, Lindsay JO, Sturm A, Windsor A, Colombel JF, Allez M et al (2012) Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohn Colitis 6(10):991–1030
Myers B, Evans DNW, Rhodes J, Evans BK, Hughes BR, Lee MG et al (1987) Metabolism and urinary excretion of 5-aminosalicylic acid in healthy volunteers when given intravenously or released for absorption at different sites in the gastrointestinal tract. Gut 28:196–200
Bondesen S, Hegnhøj J, Larsen F, Hansen SH, Hansen CP, Rasmussen SN (1991) Pharmacokinetics of 5-aminosalicylic acid in man following administration of intravenous bolus and per os slow-release formulation. Dig Dis Sci 36:1735–1740
Allgayer H, Ahnfelt NO, Kruis W et al (1989) Colonic N-acetylation of 5-aminosalicylic acid in inflammatory bowel disease. Gastroenterology 97:38–41
Klotz U (1985) Clinical pharmacokinetics of sulphasalazine, its metabolites and other prodrugs of 5-aminosalicylic acid. Clin Pharmacokinet 10:285–302
Klotz U, Maier KE (1987) Pharmacology and pharmacokinetics of 5-aminosalicylic acid. Dig Dis Sci 32:46S–50S
Meese CO, Fischer C, Klotz U (1984) Is N-acetylation of 5-aminosalicylic acid reversible in man? Br J Clin Pharmacol 18:612–615
Vree TB, Dammers E, Exler PS, Sörgel F, Maes RA (2000) Saturable active tubular reabsorption in the renal clearance of mesalazine in human volunteers. Clin Drug Invest 20:35–42
Goebell H, Klotz U, Nehlsen B, Layer P (1993) Oroileal transit of slow release 5-aminosalicylic acid. Gut 34:669–675
Layer PH, Goebell H, Keller J, Dignass A, Klotz U (1995) Delivery and fate of oral mesalamine microgranules within the human small intestine. Gastroenterology 108:1427–1433
Zhou SY, Fleisher D, Pao LH, Li C, Winward B, Zimmermann EM (1999) Intestinal metabolism and transport of 5-aminosalicylate. Drug Metab Dispos 27:479–485
Liang E, Proudfoot J, Yazdanian M (2000) Mechanisms of transport and structure-permeability relationship of sulfasalazine and its analogs in Caco-2 cell monolayers. Pharm Res 17:1168-1174
Hussain FN, Ajjan RA, Riley SA (2000) Dose loading with delayed release mesalazine: a study of tissue drug concentrations and standard pharmacokinetic parameters. Br J Clin Pharmacol 49:323–330
Frieri G, Pimpo MT, Andreoli A, Annese V, Comberlato M, Corrao G et al (1999) Prevention of post-operative recurrence of Crohn’s disease requires adequate mucosal concentration of mesalazine. Aliment Pharmacol Ther 13:557–582
Frieri G, Giacomelli R, Pimpo M, Palumbo G, Passacantando A, Pantaleoni G et al (2000) Mucosal 5-aminosalicylic acid concentration inversely correlates with severity of colonic inflammation in patients with ulcerative colitis. Gut 47:410–414
van Bodegraven AA, Boer RO, Lourens J, Tuynman HA, Sindram JW (1996) Distribution of mesalazine enemas in active and quiescent ulcerative colitis. Aliment Pharmacol Ther 10:327–332
Campieri M, Corbelli C, Gionchetti P, Brignola C, Belluzzi A, Di Febo G et al (1992) Spread and distribution of 5-ASA colonic foam and 5-ASA enema in patients with ulcerative colitis. Dig Dis Sci 37:1890–1897
Schoonjans R, de Vos M, Schelfhout A-M, Praet M, Elewaut A (1996) Distribution and concentration of 5-aminosalicylic acid in rectosigmoid biopsy specimen after rectal administration. Dis Colon Rectum 39:788–793
Almer S, Norlander B, Ström M, Osterwald H (1991) Steady-state pharmacokinetics of a new 4-gram 5-aminosalicylic acid retention enema in patients with ulcerative colitis in remission. Scand J Gastroenterol 26:327–335
Jacobsen BA, Abildgaard K, Rasmussen HH, Christensen LA, Fallingborg J, Hansen SH (1991) Availability of mesalazine (5-aminosalicylic acid) from enemas and suppositories during steady-state conditions. Scand J Gastroenterol 26:374–378
Fretland AJ, Doll MA, Leff MA, Hein DW (2001) Functional characterization of nucleotide polymorphisms in the coding region of N-acetyltransferase 1. Pharmacogenetics 11(6):511–520
Fretland AJ, Leff MA, Doll MA, Hein DW (2001) Functional characterization of human N-acetyltransferase 2 (NAT2) single nucleotide polymorphisms. Pharmacogenetics 11(3):207–215
Ohtani T, Hiroi A, Sakurane M, Furukawa F (2003) Slow acetylator genotypes as a possible risk factor for infectious mononucleosis-like syndrome induced by salazosulfapyridine. Br J Dermatol 148(5):1035–1039
Tanaka E, Taniguchi A, Urano W, Nakajima H, Matsuda Y, Kitamura Y et al (2002) Adverse effects of sulfasalazine in patients with rheumatoid arthritis are associated with diplotype configuration at the N-acetyltransferase 2 gene. J Rheumatol 29(12):2492–2499
Ricart E, Taylor WR, Loftus EV, O’Kane D, Weinshilboum RM, Tremaine WJ et al (2002) N-acetyltransferase 1 and 2 genotypes do not predict response or toxicity to treatment with mesalamine and sulfasalazine in patients with ulcerative colitis. Am J Gastroenterol 97(7):1763–1768
Dignass A, Van Assche G, Lindsay JO, Lémann M, Söderholm J, Colombel JF et al (2010) The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: current management. J Crohns Colitis 4(1):28–62
Seow CH, Benchimol EI, Steinhart AH, Griffiths AM, Otley AR (2009) Budesonide for Crohn’s disease. Expert Opin Drug Metab Toxicol 5:971–979
Campieri M, Adamo S, Valpiani D, D’Arienzo A, D’Albasio G, Pitzalis M et al (2003) Oral beclometasone dipropionate in the treatment of extensive and left-sided active ulcerative colitis: a multicenter randomised study. Aliment Pharmacol Ther 17:1471–1480
Manguso F, Balzano A (2007) Meta-analysis: the efficacy of rectal beclomethasone dipropionate vs. 5-aminosalicylic acid in mild to moderate distal ulcerative colitis. Aliment Pharmacol Ther 26:21–29
Derendorf H, Möllmann H, Barth J, Möllmann C, Tunn S, Krieg M (1991) Pharmacokinetics and oral bioavailability of hydrocortisone. J Clin Pharmacol 31:473–476
Ryrfeldt Å, Edsbäcker S, Pauwels R (1984) Kinetics of the epimeric glucocorticoid budesonide. Clin Pharmacol Ther 35:525–530
Ryrfeldt A, Andersson P, Edsbäcker S, Tönnesson M, Davies D, Pauwels R (1982) Pharmacokinetics and metabolism of budesonide, a selective glucocorticoid. Eur J Respir Dis Suppl 122:86–95
Tanner A, Bochner F, Caffin J, Halliday J, Powell L (1979) Dose-dependent prednisolone kinetics. Clin Pharmacol Ther 25:571–578
Barth J, Damoiseaux M, Möllmann H, Brandis KH, Hochhaus G, Derendorf H (1992) Pharmacokinetics and pharmacodynamics of prednisolone after intravenous and oral administration. Int J Clin Pharmacol Ther Toxicol 30:317–324
Pickup ME, Lowe JR, Leatham RA, Rhind VM, Wright V, Downie WW (1977) Dose dependent pharmacokinetics of prednisolone. Eur J Clin Pharmacol 12:213–219
Legler UF (1988) The pharmacokinetics of glucocorticoids. ISI Atlas Sci Pharmacol 345-350.
Wald JA, Law RM, Ludwig EA, Sloan RR, Middleton E Jr, Jusko WJ (1992) Evaluation of dose-related pharmacokinetics and pharmacodynamics of prednisolone in man. J Pharmacokinet Biopharm 20:567–589
Thiesen A, Thomson ABR (1996) Review article: older systemic and newer topical glucocorticosteroids and the gastrointestinal tract. Aliment Pharmacol Ther 10:487–496
Davis M, Williams R, Chakraborty J, English J, Marks V, Ideo G et al (1978) Prednisone or prednisolone for the treatment of chronic active hepatitis? A comparison of plasma availability. Br J Clin Pharmacol 5:501–505
Bergrem H, Grøttum P, Rugstad HE (1983) Pharmacokinetics and protein binding of prednisolone after oral and intravenous administration. Eur J Clin Pharmacol 24:415–419
Brogden RN, Budesonide MTD (1992) An updated review of its pharmacological properties and therapeutic efficacy in asthma and rhinitis. Drugs 44:375–407
Spencer CM, Budesonide MTD (1995) A review of its pharmacological properties and therapeutic efficacy in inflammatory bowel disease. Drugs 50:854–872
Frey BM, Frey FJ (1990) Clinical pharmacokinetics of prednisone and prednisolone. Clin Pharmacokinet 19:126–146
Rose JQ, Yurchak AM, Jusko WJ (1981) Dose-dependent pharmacokinetics of prednisone and prednisolone in man. J Pharmakokine Biopharm 9:389–417
Pickup ME (1979) Clinical pharmacokinetics of prednisone and prednisolone. Clin Pharmacokinet 4:111–128
Möllmann H, Rohdewald P, Barth J, Möllmann C, Verho M, Derendorf H (1988) Comparative pharmacokinetics of methylprednisolone phosphate and hemisuccinate in high doses. Pharm Res 5:509–513
Möllmann H, Rohdewald P, Barth J, Verho M, Derendorf H (1989) Pharmacokinetics and dose linearity testing of methylprednisolone phosphate. Biopharm Drug Dispos 10:453–464
Rohatagi S, Barth J, Möllmann H, Hochhaus G, Soldner A, Möllmann C et al (1997) Pharmacokinetics of methylprednisolone and prednisolone after single and multiple oral administration. J Clin Pharmacol 37(10):916–925
Derendorf H, Möllmann H, Rohdewald P, Rehder J, Schmidt EW (1985) Kinetics of methylprednisolone and its hemisuccinate ester. Clin Pharmacol Ther 37:502–507
Möllmann H, Barth J, Möllmann C, Tunn S, Krieg M, Derendorf H (1991) Pharmacokinetics and rectal bioavailability of hydrocortisone acetate. J Pharm Sci 80:835–836
Jönsson G, Åström A, Andersson P (1995) Budesonide is metabolized by cytochrome P4503A (CYP3A) enzymes in human liver. Drug Metabol Dispos 23:137–142
Lichtenstein GR (2001) Approach to corticosteroid-dependent and corticosteroid-refractory Crohn’s disease. Inflamm Bowel Dis 7(Suppl 1):S23–S29
Brunner M, Vogelsang H, Greinwald R, Kletter K, Kvaternik H, Schrolnberger C et al (2005) Colonic spread and serum pharmacokinetics of budesonide foam in patients with mildly to moderately active ulcerative colitis. Aliment Pharmacol Ther 22:463–470
Sandborn WJ, Danese S, D’Haens G, Moro L, Jones R, Bagin R et al (2015) Induction of clinical and colonoscopic remission of mild-to-moderate ulcerative colitis with budesonide MMX 9 mg: pooled analysis of two phase 3 studies. Aliment Pharmacol Ther 41(5):409–418
Hamedani R, Feldman RD, Feagan GB (1997) Review article: drug development in inflammatory bowel disease: budesonide—a model of targeted therapy. Aliment Pharmacol Ther 11(Suppl 3):98–108
Edsbäcker S, Wollmer P, Nilsson M (1993) Pharmacokinetics and gastrointestinal transit of budesonide controlled ileal release (CIR) capsules [abstract]. Gastroenterology 104(4 Suppl):A695
Edsbäcker S, Bengtsson B, Larsson P, Lundin P, Nilsson A, Ulmius J et al (2003) A pharmacoscintigraphic evaluation of oral budesonide given as controlled-release (Entocort) capsule. Aliment Pharmacol Ther 17:525–636
Peña AS, Kolkman JJ, Greinwald R, Tauschel HD, Nelis FG, Viergever P et al (2004) Pharmacokinetics after single and multiple oral dosing of budesonide pH-modified-release capsules in patients with distal ulcerative colitis. In: Dignass A, Gross V, Buhr HJ, James OFW (eds) Topical steroids in gastroenterology and hepatology. Kluwer Academic, Dordrecht, pp 30–35
Turner D, Walsh CM, Steinhart AH, Griffiths AM (2007) Response to corticosteroids in severe ulcerative colitis: a systematic review of the literature and a meta-regression. Clin Gastroenterol Hepatol 5:103–110
Ardizzone S, Maconi G, Russo A, Imbesi V, Colombo E, Bianchi PG (2006) Randomised controlled trial of azathioprine and 5-aminosalicylic acid for treatment of steroid dependent ulcerative colitis. Gut 55(1):47–53
Flood L, Löfberg R, Stierna P, Wikström AC (2001) Glucocorticoid receptor mRNA in patients with ulcerative colitis: a study of responders and nonresponders to glucocorticosteroid therapy. Inflamm Bowel Dis 7(3):202–209
Honda M, Orii F, Ayabe T, Imai S, Ashida T, Obara T et al (2000) Expression of glucocorticoid receptor beta in lymphocytes of patients with glucocorticoid-resistant ulcerative colitis. Gastroenterology 118(5):859–866
Bantel H, Schmitz ML, Raible A, Gregor M, Schulze-Osthoff K (2002) Critical role of NF-kappaB and stress-activated protein kinases in steroid unresponsiveness. FASEB J 16(13):1832–1834
Farrell RJ, Kelleher D (2003) Glucocorticoid resistance in inflammatory bowel disease. J Endocrinol 178(3):339–346
Dilger K, Schwab M, Fromm MF (2004) Identification of budesonide and prednisone as substrates of the intestinal drug efflux pump P-glycoprotein. Inflamm Bowel Dis 10(5):578–583
Ho GT, Nimmo ER, Tenesa A, Fennell J, Drummond H, Mowat C et al (2005) Allelic variations of the multidrug resistance gene determine susceptibility and disease behavior in ulcerative colitis. Gastroenterology 128(2):288–296
Palmieri O, Latiano A, Valvano R, D’Incà R, Vecchi M, Sturniolo GC et al (2005) Multidrug resistance 1 gene polymorphisms are not associated with inflammatory bowel disease and response to therapy in Italian patients. Aliment Pharmacol Ther 22(11-12):1129–1138
Annese V, Latiano A, Rossi L, Lombardi G, Dallapiccola B, Serafini S et al (2005) Erythrocytes-mediated delivery of dexamethasone in steroid-dependent IBD patients—a pilot uncontrolled study. Am J Gastroenterol 100(6):1370–1375
Annese V, Latiano A, Rossi L, Bossa F, Damonte G, Dallapiccola B et al (2006) The polymorphism of multi-drug resistance 1 gene (MDR1) does not influence the pharmacokinetics of dexamethasone loaded into autologous erythrocytes of patients with inflammatory bowel disease. Eur Rev Med Pharmacol Sci 10(1):27–31
Willoughby JM, Beckett J, Kumar PJ, Dawson AM (1971) Controlled trial of azathioprine in Crohn’s disease. Lancet 2:944–947
Candy S, Wright J, Gerber M, Adams G, Gerig M, Goodman R (1995) A controlled double blind study of azathioprine in the management of Crohn’s disease. Gut 37:674–678
Present DH, Korelitz BI, Wisch N, Glass JL, Sachar DB, Pasternack BS (1980) Treatment of Crohn’s disease with 6-mercaptopurine. A long-term, randomized, double-blind study. N Engl J Med 302:981–987
Pearson DC, May GR, Fick GH, Sutherland LR (1995) Azathioprine and 6-mercaptopurine in Crohn disease. A meta-analysis. Ann Intern Med 123:132–142
Rosenberg JL, Wall AJ, Levin B, Binder HJ, Kirsner JB (1975) A controlled trial of azathioprine in the management of chronic ulcerative colitis. Gastroenterology 69:96–99
Hawthorne AB, Logan RF, Hawkey CJ, Foster PN, Axon AT, Swarbrick ET et al (1992) Randomised controlled trial of azathioprine withdrawal in ulcerative colitis. BMJ 305:20–22
Markowitz J, Rosa J, Grancher K, Aiges H, Daum F (1990) Long-term 6-mercaptopurine treatment in adolescents with Crohn’s disease. Gastroenterology 99:1347–1351
Sandborn WJ (1998) Azathioprine: state of the art in inflammatory bowel disease. Scand J Gastroenterol 225(Suppl):92–99
Chalmers AH (1974) Studies on the mechanism of formation of 5-mercapto-1-methyl-4-nitroimidazole, a metabolite of the immunosuppressive drug azathioprine. Biochem Pharmacol 23:1891–1901
Chabner BA, Allegra CJ, Curt GA et al (1996) Antineoplastic agents. In: Hardman JG, Limbird LE (eds) Goodman & Gilman’s the pharmacological basis of therapeutics, 9th edn. McGraw-Hill, New York, pp 1233–1287
Tidd DM, Paterson AR (1974) A biochemical mechanism for the delayed cytotoxic reaction of 6-mercaptopurine. Cancer Res 34:738–746
Blaker PA, Arenas-Hernandez M, Smith MA, Shobowale-Bakre EA, Fairbanks L, Irving PM et al (2013) Mechanism of allopurinol induced TPMT inhibition. Biochem Pharmacol 86(4):539–547
Present DH (1989) 6-Mercaptopurine and other immunosuppressive agents in the treatment of Crohn’s disease and ulcerative colitis. Gastroenterol Clin North Am 18(1):57–71
Lennard L (1992) The clinical pharmacology of 6-mercaptopurine. Eur J Clin Pharmacol 43(4):329–339
Sandborn WJ, Van Os EC, Zins BJ, Tremaine WJ, Mays DC, Lipsky JJ (1995) An intravenous loading dose of azathioprine decreases the time to response in patients with Crohn’s disease. Gastroenterology 109:1808–1817
Lennard L, Lilleyman JS, Van Loon J, Weinshilboum RM (1990) Genetic variation in response to 6-mercaptopurine for childhood acute lymphoblastic leukaemia. Lancet 336:225–229
Lilleyman JS, Lennard L (1994) Mercaptopurine metabolism and risk of relapse in childhood lymphoblastic leukaemia. Lancet 343:1188–1190
Weinshilboum RM, Raymond FA, Pazmino PA (1978) Human erythrocyte thiopurine methyltransferase: radiochemical microassay and biochemical properties. Clin Chim Acta 85:323–333
Pettersson BAS, Albertioni F, Soderhall S, Peterson C (2002) Differences between children and adults in thiopurine methyltransferase activity and metabolite formation during thiopurine therapy: possible role of concomitant methotrexate. Ther Drug Monit 24:351–358
Evans WE, Hon YY, Bomgaars L, Coutre S, Holdsworth M, Janco R et al (2001) Preponderance of thiopurine S-methyltransferase deficiency and heterozygosity among patients intolerant to mercaptopurine or azathioprine. J Clin Oncol 19:2293–2301
Evans WE, Horner M, Chu YQ, Kalwinsky D, Roberts WM (1991) Altered mercaptopurine metabolism, toxic effects, and dosage requirement in a thiopurine methyltransferase-deficient child with acute lymphocytic leukemia. J Pediatr 119:985–989
Derijks LJ, Gilissen LP, Engels LG, Bos LP, Bus PJ, Lohman JJ et al (2004) Pharmacokinetics of 6-mercaptopurine in patients with inflammatory bowel disease: implications for therapy. Ther Drug Monit 26(3):311–318
Gilissen LP, Derijks LJ, Bos LP, Verhoeven HM, Bus PJ, Hooymans PM et al (2004) Some cases demonstrating the clinical usefulness of therapeutic drug monitoring in thiopurine-treated inflammatory bowel disease patients. Eur J Gastroenterol Hepatol 16(7):705–710
Colombel JF, Ferrari N, Debuysere H, Marteau P, Gendre JP, Bonaz B et al (2000) Genotypic analysis of thiopurine S-methyltransferase in patients with Crohn’s disease and severe myelosuppression during azathioprine therapy. Gastroenterology 118(6):1025–1030
Szumlanski CL, Weinshilboum RM (1995) Sulphasalazine inhibition of thiopurine methyltransferase: possible mechanism for interaction with 6-mercaptopurine and azathioprine. Br J Clin Pharmacol 39(4):456–459
Pettersson B, Almer S, Albertioni F, Söderhäll S, Peterson C (2002) Differences between children and adults in thiopurine methyltransferase activity and metabolite formation during thiopurine therapy: possible role of concomitant methotrexate. Ther Drug Monit 24(3):351–358
Krynetski EY, Tai HL, Yates CR, Fessing MY, Loennechen T, Schuetz JD et al (1996) Genetic polymorphism of thiopurine S-methyltransferase: clinical importance and molecular mechanisms. Pharmacogenetics 6:279–290
Krynetski EY, Evans WE (2000) Genetic polymorphism of thiopurine S-methyltransferase: molecular mechanisms and clinical importance. Pharmacology 61:136–146
Weinshilboum R (2001) Thiopurine pharmacogenetics: clinical and molecular studies of thiopurine methyltransferase. Drug Metab Dispos 29:601–615
Lindqvist M, Haglund S, Almer S, Peterson C, Taipalensu J, Hertervig E et al (2004) Identification of two novel sequence variants affecting thiopurine methyltransferase enzyme activity. Pharmacogenetics 14(4):261–265
Roberts RL, Gearry RB, Bland MV, Sies CW, George PM, Burt M et al (2008) Trinucleotide repeat variants in the promoter of the thiopurine S-methyltransferase gene of patients exhibiting ultra-high enzyme activity. Pharmacogenet Genomics 18:434–438
Wong DR, Derijks LJ, den Dulk MO, Gemmeke EH, Hooymans PM (2007) The role of xanthine oxidase in thiopurine metabolism: a case report. Ther Drug Monit 29:845–848
Smith MA, Marinaki AM, Arenas M, Shobowale-Bakre M, Lewis CM, Ansari A et al (2009) Novel pharmacogenetic markers for treatment outcome in azathioprine-treated inflammatory bowel disease. Aliment Pharmacol Ther 30:375–384
Marinaki AM, Ansari A, Duley JA, Arenas M, Sumi S, Lewis CM et al (2004) Adverse drug reactions to azathioprine therapy are associated with polymorphism in the gene encoding inosine triphosphate pyrophosphatase (ITPase). Pharmacogenetics 14:181–187
Derijks LJ, Wong DR (2010) Pharmacogenetics of thiopurines in inflammatory bowel disease. Curr Pharm Des 16:145–154
Cuffari C, Theoret Y, Latour S, Seidman G (1996) 6-Mercaptopurine metabolism in Crohn’s disease: correlation with efficacy and toxicity. Gut 39:401–406
Lowry PW, Franklin CL, Weaver AL, Pike MG, Mays DC, Tremaine WJ et al (2001) Measurement of thiopurine methyltransferase activity and azathioprine metabolites in patients with inflammatory bowel disease. Gut 49:665–670
Reuther LO, Sonne J, Larsen NE, Larsen B, Christensen S, Rasmussen SN et al (2003) Pharmacological monitoring of azathioprine therapy. Scand J Gastroenterol 38:972–977
Dubinsky MC, Lamothe S, Yang HY, Targan SR, Sinnett D, Théorêt Y et al (2000) Pharmacogenomics and metabolite measurement for 6-mercaptopurine therapy in inflammatory bowel disease. Gastroenterology 118:705–713
Osterman MT, Kundu R, Lichtenstein GR, Lewis JD (2006) Association of 6-thioguanine nucleotide levels and inflammatory bowel disease activity: a meta-analysis. Gastroenterology 130:1047–1053
Wright S, Sanders DS, Lobo AJ, Lennard L (2004) Clinical significance of azathioprine active metabolite concentrations in inflammatory bowel disease. Gut 53:1123–1128
Ansari A, Arenas M, Greenfield SM, Morris D, Lindsay J, Gilshenan K et al (2008) Prospective evaluation of the pharmacogenetics of azathioprine in the treatment of inflammatory bowel disease. Aliment Pharmacol Ther 28:973–983
Dubinsky MC, Yang H, Hassard PV, Seidman EG, Kam LY, Abreu MT et al (2002) 6-MP metabolite profiles provide a biochemical explanation for 6-MP resistance in patients with inflammatory bowel disease. Gastroenterology 122:904–915
Gardiner SJ, Gearry RB, Burt MJ, Ding SL, Barclay ML (2008) Severe hepatotoxicity with high 6-methylmercaptopurine nucleotide concentrations after thiopurine dose escalation due to low 6-thioguanine nucleotides. Eur J Gastroenterol Hepatol 20:1238–1242
Roblin X, Biroulet LP, Phelip JM, Nancey S, Flourie B (2008) A 6-thioguanine nucleotide threshold level of 400 pmol/8 x 10 erythrocytes predicts azathioprine refractoriness in patients with inflammatory bowel disease and normal TPMT activity. Am J Gastroenterol 103:3115–3122
Mantzaris GJ, Roussos A, Kalantzis C, Koilakou S, Raptis N, Kalantzis N (2007) How adherent to treatment with azathioprine are patients with Crohn’s disease in long-term remission? Inflamm Bowel Dis 13:446–450
Gearry RB, Barclay ML (2005) Azathioprine and 6-mercaptopurine pharmacogenetics and metabolite monitoring in inflammatory bowel disease. J Gastroenterol Hepatol 20:1149–1157
Gonzalez-Lama Y, Bermejo F, Lopez-San-roman A, Garcia-Sanchez V, Esteve M, Cabriada JL et al (2011) Thiopurine methyl-transferase activity and azathioprine metabolite concentrations do not predict clinical out-come in thiopurine-treated inflammatory bowel disease patients. Aliment Pharmacol Ther 34:544–554
van Asseldonk DP, de Boer NK, van Bodegraven AA (2011) Thiopurine metabolite measurement—not for everyone. Aliment Pharmacol Ther 34(8):1038–1039
Siegel CA, Sands BE (2005) Review article: practical management of inflammatory bowel disease patients taking immunomodulators. Aliment Pharmacol Ther 22:1–16
Castiglione F, Del Vecchio Blanco G, Rispo A, Mazzacca G (2000) Prevention of pancreatitis by weekly amylase assay in patients with Crohn’s disease treated with azathioprine. Am J Gastroenterol 95:2394–2395
de Boer NK, Wong DR, Jharap B, de Graaf P, Hooymans PM, Mulder CJ et al (2007) Dose-dependent influence of 5-aminosalicylates on thiopurine metabolism. Am J Gastroenterol 102:2747–2753
Smith MA, Blaker P, Marinaki AM, Anderson SH, Irving PM, Sanderson JD (2012) Optimising outcome on thiopurines in inflammatory bowel disease by co-prescription of allopurinol. J Crohn's Colitis 6:905–912
Sparrow MP, Hande SA, Friedman S, Lim WC, Reddy SI, Cao D et al (2005) Allopurinol safely and effectively optimizes tioguanine metabolites in inflammatory bowel disease patients not responding to azathioprine and mercaptopurine. Aliment Pharmacol Ther 22(5):441–446
Sparrow MP, Hande SA, Friedman S, Cao D, Hanauer SB (2007) Effect of allopurinol on clinical outcomes in inflammatory bowel disease nonresponders to azathioprine or 6-mercaptopurine. Clin Gastroenterol Hepatol 5(2):209–214
Seinen ML, van Asseldonk DP, de Boer NK, Losekoot N, Smid K, Mulder CJ et al (2013) The effect of allopurinol and low-dose thiopurine combination therapy on the activity of three pivotal thiopurine metabolizing enzymes: results from a prospective pharmacological study. J Crohns Colitis 7(10):812–819
McGuire JJ, Hsieh P, Bertino JR (1984) Enzymatic synthesis of polyglutamate derivatives of 7-hydroxymethotrexate. Biochem Pharmacol 33:1355–1361
Sholar PW, Baram J, Seither R, Allegra CJ (1988) Inhibition of folate-dependent enzymes by 7-OH-methotrexate. Biochem Pharmacol 37:3531–3534
Schmiegelow K (2009) Advances in individual prediction of methotrexate toxicity: a review. Br J Haematol 146:489–503
Grim J, Chladek J, Martinkova J (2003) Pharmacokinetics and pharmacodynamics of methotrexate in non-neoplastic diseases. Clin Pharmacokinet 42:139–151
Hendel J, Nyfors A (1984) Nonlinear renal elimination kinetics of methotrexate due to saturation of renal tubular reabsorption. Eur J Clin Pharmacol 26:121–124
Oren R, Moshkowitz M, Odes S, Becker S, Keter D, Pomeranz I et al (1997) Methotrexate in chronic active Crohn’s disease: a double-blind, randomized, Israeli multicenter trial. Am J Gastroenterol 92(12):2203–2209
Lémann M, Chamiot-Prieur C, Mesnard B, Halphen M, Messing B, Rambaud JC et al (1996) Methotrexate for the treatment of refractory Crohn’s disease. Aliment Pharmacol Ther 10(3):309–314
Feagan BG, Fedorak RN, Irvine EJ, Wild G, Sutherland L, Steinhart AH et al (2000) A comparison of methotrexate with placebo for the maintenance of remission in Crohn’s disease. North American Crohn’s Study Group Investigators. N Engl J Med 342(22):1627–1632
Moshkowitz M, Oren R, Tishler M, Konikoff FM, Graff E, Brill S et al (1997) The absorption of low-dose methotrexate in patients with inflammatory bowel disease. Aliment Pharmacol Ther 11(3):569–573
Wan SH, Huffman DH, Azarnoff DL, Stephens R, Hoogstraten B (1974) Effect of route of administration and effusions on methotrexate pharmacokinetics. Cancer Res 34(12):3487–3491
Egan LJ, Sandborn WJ, Tremaine WJ, Leighton JA, Mays DC, Pike MG et al (1999) A randomized dose-response and pharmacokinetic study of methotrexate for refractory inflammatory Crohn’s disease and ulcerative colitis. Aliment Pharmacol Ther 13(12):1597–1604
Seideman P, Beck O, Eksborg S, Wennberg M (1993) The pharmacokinetics of methotrexate and its 7-hydroxy metabolite in patients with rheumatoid arthritis. Br J Clin Pharmacol 35(4):409–412
Angelis-Stoforidis P, Vajda FJ, Christophidis N (1999) Methotrexate polyglutamate levels in circulating erythrocytes and polymorphs correlate with clinical efficacy in rheumatoid arthritis. Clin Exp Rheumatol 17(3):313–320
Brooks AJ, Begg EJ, Zhang M, Frampton CM, Barclay ML (2007) Red blood cell methotrexate polyglutamate concentrations in inflammatory bowel disease. Ther Drug Monit 29(5):619–625
Ranganathan P (2008) An update on methotrexate pharmacogenetics in rheumatoid arthritis. Pharmacogenomics 9(4):439–451
Herrlinger KR, Cummings JR, Barnardo MC, Schwab M, Ahmad T, Jewell DP (2005) The pharmacogenetics of methotrexate in inflammatory bowel disease. Pharmacogenet Genomics 15(10):705–711
Soon S, Ansari A, Marinaki T, Arenas M, Magdalinou K, Sanderson J (2004) C677T and A1298C methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms does not predict toxicity or efficacy of methotrexate in patients with inflammatory bowel disease. Gastroenterology 126:A210
Schwahn B, Rozen R (2001) Polymorphisms in the methylenetetrahydrofolate reductase gene: clinical consequences. Am J Pharmacogenomics 1:189–201
Berkun Y, Levartovsky D, Rubinow A, Orbach H, Aarnar S, Grenader T et al (2001) Methotrexate related adverse effects in patients with rheumatoid arthritis are associated with the A1298C polymorphism of the MTHFR gene. Ann Rheum Dis 63:1227–1231
Hughes LB, Beasley TM, Patel H, Tiwari HK, Morgan SL, Baggott JE et al (2006) Racial or ethnic differences in allele frequencies of single-nucleotide polymorphisms in the methylenetetrahydrofolate reductase gene and their influence on response to methotrexate in rheumatoid arthritis. Ann Rheum Dis 65:1213–1218
Dervieux T, Furst D, Lein DO, Capps R, Smith K, Walsh M et al (2004) Polyglutamation of methotrexate with common polymorphisms in reduced folate carrier, aminoimidazole carboxamide ribonucleotide transformylase, and thymidylate synthase are associated with methotrexate effects in rheumatoid arthritis. Arthritis Rheum 50:2766–2774
Weisman MH, Furst DE, Park GS, Kremer IM, Smith KM, Wallace DJ et al (2006) Risk genotypes in folate-dependent enzymes and their association with methotrexate-related side effects in rheumatoid arthritis. Arthritis Rheum 54:607–612
Feagan BG, Fedorak RN, Irvine EJ, Wild G, Sutherland L, Steinhart AH et al (2000) A comparison of methotrexate with placebo for the maintenance of remission in Crohn’s disease. North American Crohn’s Study Group Investigators. N Engl J Med 342:1627–1632
Feagan BG, Alfadhli A (2004) Methotrexate in inflammatory bowel disease. Gastroenterol Clin North Am 33:407–420
Seinen ML, Ponsioen CY, de Boer NK, Oldenburg B, Bouma G, Mulder CJ et al (2013) Sustained clinical benefit and tolerability of methotrexate monotherapy after thiopurine therapy in patients with Crohn’s disease. Clin Gastroenterol Hepatol 11(6):667–672
Ptachcinski RJ, Venkataramanan R, Rosenthal JT, Burckart GJ, Taylor RJ, Hakala TR (1985) Cyclosporine kinetics in renal transplantation. Clin Pharmacol Ther 38(3):296–300
Lindholm A, Kahan BD (1993) Influence of cyclosporine pharmacokinetics, trough concentrations, and AUC monitoring on outcome after kidney transplantation. Clin Pharmacol Ther 54(2):205–218
Brynskov J, Freund L, Campanini MC, Kampmann JP (1992) Cyclosporin pharmacokinetics after intravenous and oral administration in patients with Crohn’s disease. Scand J Gastroenterol 27:961–967
Wallemacq PE, Lhoest G, Latinne D, De Bruyère M (1989) Isolation, characterization and in vitro activity of human cyclosporin A metabolites. Transplant Proc 21:906–910
Quesniaux VF (1990) Pharmacology of cyclosporine (Sandimmune). III. Immunochemistry and monitoring. Pharmacol Rev 41:249–258
Saeki T, Ueda K, Tanigawara Y, Hori R, Komano T (1993) Human P-glycoprotein transports cyclosporin A and FK506. J Biol Chem 268(9):6077–6080
Lown KS, Mayo RR, Leichtman AB, Hsiao HL, Turgeon DK, Schmiedlin-Ren P et al (1997) Role of intestinal P-glycoprotein (mdr1) in interpatient variation in the oral bioavailability of cyclosporine. Clin Pharmacol Ther 62:248–260
Sandborn WJ, Strong RM, Forland SC, Chase RE, Cutler RE (1991) The pharmacokinetics and colonic tissue concentrations of cyclosporine after i.v., oral, and enema administration. J Clin Pharmacol 31(1):76–80
Brynskov J, Freund L, Rasmussen SN, Lauritsen K, de Muckadell OS, Williams N et al (1989) A placebo-controlled, double-blind, randomized trial of cyclosporine therapy in active chronic Crohn’s disease. N Engl J Med 321:845–850
Lichtiger S, Present DH (1990) Preliminary report: cyclosporin in treatment of severe active ulcerative colitis. Lancet 336:16–19
Kornbluth A, Lichtiger S, Present D, Hanauer S (1994) Long-term results of oral cyclosporin in patients with severe ulcerative colitis: a double-blind randomized multicenter trial. Gastroenterology 106:A714
Arts J, D’Haens G, Zeegers M, Van Assche G, Hiele M, D’Hoore A et al (2004) Long-term outcome of treatment with intravenous cyclosporin in patients with severe ulcerative colitis. Inflamm Bowel Dis 10:73–78
Moskovitz DN, Van Assche G, Maenhout B, Arts J, Ferrante M, Vermeire S et al (2006) Incidence of colectomy during long-term follow-up after cyclosporine-induced remission of severe ulcerative colitis. Clin Gastroenterol Hepatol 4:760–765
Utecht KN, Hiles JJ, Kolesar J (2006) Effects of genetic polymorphisms on the pharmacokinetics of calcineurin inhibitors. Am J Health Syst Pharm 63:2340–2348
Jiang Z, Wang Y, Xu P, Liu R, Zhao X, Chen F (2008) Meta-analysis of the effect of MDR1 C3435T polymorphism on cyclosporine pharmacokinetics. Basic Clin Pharmacol Toxicol 103:433–444
Mardigyan V, Giannetti N, Cecere R, Besner JG, Cantarovich M (2005) Best single time points to predict the area-under-the-curve in long-term heart transplant patients taking mycophenolate mofetil in combination with cyclosporine or tacrolimus. J Heart Lung Transplant 24:1614–1618
Keown P, Landsberg D, Halloran P, Shoker A, Rush D, Jeffery J et al (1996) A randomized, prospective multicenter pharmacoepidemiologic study of cyclosporine microemulsion in stable renal graft recipients. Transplantation 62:1744–1752
Cantarovich M, Barkun JS, Tchervenkov JI, Besner JG, Aspeslet L, Metrakos P (1998) Comparison of neural dose monitoring with cyclosporine trough levels versus 2-hr postdose levels in stable liver transplant patients. Transplantation 66:1621–1627
Cantarovich M, Besner JG, Barkun JS, Elstein E, Loertscher R (1998) Two-hour cyclosporine level determination is the appropriate tool to monitor neoral therapy. Clin Transplant 12:243–249
Mahalati K, Kahan BD (2000) Pharmacological surrogates of allograft outcome. Ann Transplant 5:14–23
Present DH, Lichtiger S (1994) Efficacy of cyclosporine in treatment of fistula of Crohn’s disease. Dig Dis Sci 39:374–380
Plosker GL, Foster RH (2000) Tacrolimus: a further update of its pharmacology and therapeutic use in the management of organ transplantation. Drugs 59:323–389
Filler G, Grygas R, Mai I, Stolpe HJ, Greiner C, Bauer S et al (1997) Pharmacokinetics of tacrolimus (FK 506) in children and adolescents with renal transplants. Nephrol Dial Transplant 12:1668–1671
Dirks NL, Huth B, Yates CR, Meibohm B (2004) Pharmacokinetics of immunosuppressants: a perspective on ethnic differences. Int J Clin Pharmacol Ther 42(12):701–718
Nagase K, Iwasaki K, Nozaki K, Noda K (1994) Distribution and protein binding of FK506, a potent immunosuppressive macrolide lactone, in human blood and its uptake by erythrocytes. J Pharm Pharmacol 46:113–117
Venkataramanan R, Swaminathan A, Prasad T, Jain A, Zuckerman S, Warty V et al (1995) Clinical pharmacokinetics of tacrolimus. Clin Pharmacokinet 29:404–430
Kelly P, Kahan BD (2002) Review: metabolism of immunosuppressant drugs. Curr Drug Metab 3:275–287
Möller A, Iwasaki K, Kawamura A, Teramura Y, Shiraga T, Hata T et al (1999) The disposition of 14C-labelled tacrolimus after intravenous and oral administration in healthy human subjects. Drug Metab Dispos 27:633–666
Spencer CM, Goa KL, Gillis JC (1997) Tacrolimus: an update of its pharmacology and clinical efficacy in the management of organ transplantation. Drugs 54:925–975
Ogata H, Matsui T, Nakamura M, Iida M, Takazoe M, Suzuki Y et al (2006) A randomised dose finding study of oral tacrolimus (FK506) therapy in refractory ulcerative colitis. Gut 55:1255–1262
Sandborn WJ, Present DH, Isaacs KL, Wolf DC, Greenberg E, Hanauer SB et al (2003) Tacrolimus for the treatment of fistulas in patients with Crohn’s disease: a randomized, placebo-controlled trial. Gastroenterology 125:380–388
Webster A, Woodroffe RC, Taylor RS, Chapman JR, Craig JC (2005) Tacrolimus versus cyclosporin as primary immunosuppression for kidney transplant recipients. Cochrane Database Syst Rev 4, CD003961
Haddad EM, McAlister VC, Renouf E, Malthaner R, Kjaer MS, Gluud LL (2006) Cyclosporin versus tacrolimus for liver transplanted patients. Cochrane Database Syst Rev 4, CD005161
Larriba J, Imperiali N, Groppa R, Giordani C, Algranatti S, Redal MA (2010) Pharmacogenetics of immunosuppressant polymorphism of CYP3A5 in renal transplant recipients. Transplant Proc 42:257–259
Macphee IA, Fredericks S, Tai T, Syrris P, Carter ND, Johnston A et al (2002) Tacrolimus pharmacogenetics: polymorphisms associated with expression of cytochrome p450-3A5 and P-glycoprotein correlate with dose requirement. Transplantation 74:1486–1489
Tsuchiya N, Satoh S, Tada H, Li Z, Ohyama C, Sato K et al (2004) Influence of CYP3A5 and MDR1 (ABCB1) polymorphisms on the pharmacokinetics of tacrolimus in renal transplant recipients. Transplantation 78:1182–1187
Zhao W, Elie V, Roussey G, Brochard K, Niaudet P, Leroy V et al (2009) Population pharmacokinetics and pharmacogenetics of tacrolimus in de novo pediatric kidney transplant recipients. Clin Pharmacol Ther 86:609–618
Filler G, Lepage N, Delisle B, Mai I (2001) Effect of cyclosporine on mycophenolic acid area under the concentration-time curve in pediatric kidney transplant recipients. Ther Drug Monit 23:514–519
Kuypers DRJ, Claes K, Evenepoel P, Maes B, Coosemans W, Pirenne J et al (2004) Time-related clinical determinants of long-term tacrolimus pharmacokinetics in combination therapy with mycophenolic acid and corticosteroids: a prospective study in one hundred de novo renal transplant recipients. Clin Pharmacokinet 43:741–762
Balbontin FG, Kiberd B, Squires J, Singh D, Fraser A, Belitsky P et al (2003) Tacrolimus monitoring by simplified sparse sampling under the concentration time curve. Transplant Proc 35:2445–2448
Scholten EM, Cremers SCLM, Schoemaker RC, Rowshani AT, van Kan EJ, den Hartigh J et al (2005) AUC-guided dosing of tacrolimus prevents progressive systemic overexposure in renal transplant recipients. Kidney Int 67:2440–2447
Baumgart DC, Macdonald JK, Feagan B (2008) Tacrolimus (FK506) for induction of remission in refractory ulcerative colitis. Cochrane Database Syst Rev 3, CD007216
Baumann A (2006) Early development of therapeutic biologics: pharmacokinetics. Curr Drug Metab 7:15–21
Flessner MF, Dedrick RL (1994) Monoclonal antibody delivery to intraperitoneal tumors in rats: effects of route of administration and intraperitoneal solution osmolality. Cancer Res 54:4376–4384
Baxter LT, Jain RK (1991) Transport of fluid and macromolecules in tumors: IV. A microscopic model of the perivascular distribution. Microvasc Res 41:252–272
Garg A, Balthasar JP (2007) Physiologically-based pharmacokinetic (PBPK) model to predict IgG tissue kinetics in wild-type and FcRn-knockout mice. J Pharmacokinet Pharmacodyn 34:687–709
Waldmann TA, Strober W (1969) Metabolism of immunoglobulins. Prog Allergy 13:1–110
Comber PG, Gomez F, Rossman MD, Schreiber AD (1989) Receptors for the Fc portion of immunoglobulin G (Fc gamma R) on human monocytes and macrophages. Prog Clin Biol Res 297:273–285
Dall’Ozzo S, Tartas S, Paintaud G, Cartron G, Colombat P, Bardos P et al (2004) Rituximab-dependent cytotoxicity by natural killer cells: influence of FCGR3A polymorphism on the concentration-effect relationship. Cancer Res 64:4664–4669
Mellman I, Plutner H (1984) Internalization and degradation of macrophage Fc receptors bound to polyvalent immune complexes. J Cell Biol 98:1170–1177
Press OW, Hansen JA, Farr A, Martin PJ (1988) Endocytosis and degradation of murine anti-human CD3 monoclonal antibodies by normal and malignant T-lymphocytes. Cancer Res 48:2249–2257
Lammerts van Bueren JJ, Bleeker WK, Bøgh HO, Houtkamp M, Schuurman J, van de Winkel JG et al (2006) Effect of target dynamics on pharmacokinetics of a novel therapeutic antibody against the epidermal growth factor receptor: implications for the mechanisms of action. Cancer Res 66:7630–7638
Duconge J, Fernández-Sánchez E, Macías A, Castillo R, Garcia I, Beausoleil I et al (2002) Monoclonal anti-EGF receptor antibody (ior-R3) pharmacokinetic study in tumor bearing nude mice: role of the receptor-mediated endocytosis on drug clearance. Eur J Drug Metab Pharmacokinet 27:101–105
Coffey GP, Stefanich E, Palmieri S, Eckert R, Padilla-Eagar J, Fielder PJ et al (2004) In vitro internalization, intracellular transport, and clearance of an anti-CD11a antibody (Raptiva) by human T-cells. J Pharmacol Exp Ther 310:896–904
Junghans RP, Anderson CL (1996) The protection receptor for IgG catabolism is the beta2-microglobulin-containing neonatal intestinal transport receptor. Proc Natl Acad Sci U S A 93:5512–5516
Ghetie V, Ward ES (2000) Multiple roles for the major histocompatibility complex class I- related receptor FcRn. Annu Rev Immunol 18:739–766
Israel EJ, Wilsker DF, Hayes KC, Schoenfeld D, Simister NE (1996) Increased clearance of IgG in mice that lack beta 2-microglobulin: possible protective role of FcRn. Immunology 89:573–578
DeNardo GL, Bradt BM, Mirick GR, DeNardo S (2003) Human antiglobulin response to foreign antibodies: therapeutic benefit? Cancer Immunol Immunother 52:309–316
Schellekens H (2002) Immunogenicity of therapeutic proteins: clinical implications and future prospects. Clin Ther 24:1720–17440
Schreiber S, Khaliq-Kareemi M, Lawrance IC, Thomsen OØ, Hanauer SB, McColm J, PRECISE 2 Study Investigators et al (2007) Maintenance therapy with certolizumab pegol for Crohn’s disease. N Engl J Med 357(3):239–250
Karmiris K, Paintaud G, Noman M, Magdelaine-Beuzelin C, Ferrante M, Degenne D et al (2009) Influence of trough serum levels and immunogenicity on long-term outcome of adalimumab therapy in Crohn’s disease. Gastroenterology 137(5):1628–1640
Sandborn WJ, Hanauer SB, Rutgeerts P, Fedorak RN, Lukas M, MacIntosh DG et al (2007) Adalimumab for maintenance treatment of Crohn’s disease: results of the CLASSIC II trial. Gut 56(9):1232–1239
Schreiber S, Rutgeerts P, Fedorak RN, Khaliq-Kareemi M, Kamm MA, Boivin M, CDP870 Crohn’s Disease Study Group et al (2005) A randomized, placebo-controlled trial of certolizumab pegol (CDP870) for treatment of Crohn’s disease. Gastroenterology 129:807–818
de Vries MK, Wolbink GJ, Stapel SO, de Vrieze H, van Denderen JC, Dijkmans BA et al (2007) Decreased clinical response to infliximab in ankylosing spondylitis is correlated with anti-infliximab formation. Ann Rheum Dis 66:1252–1254
Wolbink GJ, Vis M, Lems W, Voskuyl AE, de Groot E, Nurmohamed MT et al (2006) Development of antiinfliximab antibodies and relationship to clinical response in patients with rheumatoid arthritis. Arthritis Rheum 54:711–715
Fasanmade AA, Adedokun OJ, Olson A, Strauss R, Davis HM (2010) Serum albumin concentration: a predictive factor of infliximab pharmacokinetics and clinical response in patients with ulcerative colitis. Int J Clin Pharmacol Ther 48:297–308
Kevans D, Murthy S, Iacono A, Silverberg MS, Greenberg GR (2012) Accelerated clearance of serum infliximab during induction therapy for acute ulcerative colitis is associated with treatment failure. Gastroenterology 142(Suppl 1):S384–S385
Fasanmade AA, Adedokun OJ, Blank M, Zhou H, Davis HM (2011) Pharmacokinetic properties of infliximab in children and adults with Crohn’s disease: a retrospective analysis of data from 2 phase III clinical trials. Clin Ther 33:946–964
Vermeire S, Noman M, Van Assche G, Baert F, D’Haens G, Rutgeerts P (2007) Effectiveness of concomitant immunosuppressive therapy in suppressing the formation of antibodies to infliximab in Crohn’s disease. Gut 56:1226–1231
Seow CH, Newman A, Irwin SP, Steinhart AH, Silverberg MS, Greenberg GR (2010) Trough serum infliximab: a predictive factor of clinical outcome for infliximab treatment in acute ulcerative colitis. Gut 59:49–54
Colombel JF, Sandborn WJ, Reinisch W, Mantzaris GJ, Kornbluth A, Rachmilewitz D, SONIC Study Group et al (2010) Infliximab, azathioprine, or combination therapy for Crohn’s disease. N Engl J Med 362:1383–1395
Fasanmade AA, Adedokun OJ, Ford J, Hernandez D, Johanns J, Hu C et al (2009) Population pharmacokinetic analysis of infliximab in patients with ulcerative colitis. Eur J Clin Pharmacol 65:1211–1228
Louis E (2013) Strategic use of immunosuppressants and anti-TNF in inflammatory bowel disease. Dig Dis 31(2):207–212
Mould DR, Green B (2010) Pharmacokinetics and pharmacodynamics of monoclonal antibodies: concepts and lessons for drug development. Biodrugs 24:23–39
Ordás I, Mould DR, Feagan BG, Sandborn WJ (2012) Anti-TNF monoclonal antibodies in inflammatory bowel disease: pharmacokinetics-based dosing paradigms. Clin Pharmacol Ther 91:635–646
Tabrizi M, Bornstein GG, Suria H (2010) Biodistribution mechanisms of therapeutic monoclonal antibodies in health and disease. AAPS J 12:33–43
Morell A, Terry WD, Waldmann TA (1970) Metabolic properties of IgG subclasses in man. J Clin Invest 49:673–680
Wolbink GJ, Voskuyl AE, Lems WF, de Groot E, Nurmohamed MT, Tak PP et al (2005) Relationship between serum trough infliximab levels, pretreatment C reactive protein levels, and clinical response to infliximab treatment in patients with rheumatoid arthritis. Ann Rheum Dis 64:704–707
Takeuchi T, Miyasaka N, Tatsuki Y, Yano T, Yoshinari T, Abe T et al (2011) Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infliximab therapy in patients with rheumatoid arthritis. Ann Rheum Dis 70:1208–1215
Olsen T, Goll R, Cui G, Christiansen I, Florholmen J (2009) TNF-alpha gene expression in colorectal mucosa as a predictor of remission after induction therapy with infliximab in ulcerative colitis. Cytokine 46:222–227
Jamnitski A, Bartelds GM, Nurmohamed MT, van Schouwenburg PA, van Schaardenburg D, Stapel SO et al (2011) The presence or absence of antibodies to infliximab or adalimumab determines the outcome of switching to etanercept. Ann Rheum Dis 70:284–288
Ungar B, Chowers Y, Yavzori M, Picard O, Fudim E, Har-Noy O et al (2014) The temporal evolution of antidrug antibodies in inflammatory bowel disease patients treated with infliximab. Gut 63(8):1258–1264. doi:10.1136/gutjnl-2013-305259
Steenholdt C, Al-khalaf M, Brynskov J, Bendtzen K, Thomsen OØ, Ainsworth MA (2012) Clinical implications of variations in anti-infliximab antibody levels in patients with inflammatory bowel disease. Inflamm Bowel Dis 18:2209–2217
Vande Casteele N, Gils A, Singh S, Ohrmund L, Hauenstein S, Rutgeerts P et al (2013) Antibody response to infliximab and its impact on pharmacokinetics can be transient. Am J Gastroenterol 108:962–971
Maser EA, Villela R, Silverberg MS, Greenberg GR (2006) Association of trough serum infliximab to clinical outcome after scheduled maintenance treatment for Crohn’s disease. Clin Gastroenterol Hepatol 4:1248–1254
Reinisch W, Sandborn WJ, Hommes DW, D’Haens G, Hanauer S, Schreiber S et al (2011) Adalimumab for induction of clinical remission in moderately to severely active ulcerative colitis: results of a randomised controlled trial. Gut 60:780–787
Bartelds GM, Wijbrandts CA, Nurmohamed MT, Stapel S, Lems WF, Aarden L et al (2010) Anti-infliximab and anti-adalimumab antibodies in relation to response to adalimumab in infliximab switchers and anti-tumour necrosis factor naive patients: a cohort study. Ann Rheum Dis 69:817–821
West RL, Zelinkova Z, Wolbink GJ, Kuipers EJ, Stokkers PC, van der Woude CJ (2008) Immunogenicity negatively influences the outcome of adalimumab treatment in Crohn’s disease. Aliment Pharmacol Ther 28:1122–1126
Bultman E, de Haar C, van Liere-Baron A, Verhoog H, West RL, Kuipers EJ et al (2012) Predictors of dose escalation of adalimumab in a prospective cohort of Crohn’s disease patients. Aliment Pharmacol Ther 35:335–341
Peyrin-Biroulet L, Gonzalez F, Dubuquoy L, Rousseaux C, Dubuquoy C, Decourcelle C et al (2012) Mesenteric fat as a source of C reactive protein and as a target for bacterial translocation in Crohn’s disease. Gut 61:78–85
Rutgeerts P, Sandborn WJ, Feagan BG, Reinisch W, Olson A, Johanns J et al (2005) Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 353:2462–2476
Sandborn WJ, van Assche G, Reinisch W, Colombel JF, D’Haens G, Wolf DC et al (2012) Adalimumab induces and maintains clinical remission in patients with moderate-to-severe ulcerative colitis. Gastroenterology 142:257–265
Hanauer SB, Feagan BG, Lichtenstein GR, Mayer LF, Schreiber S, Colombel JF et al (2002) Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial. Lancet 359:1541–1549
Hanauer SB, Sandborn WJ, Rutgeerts P, Fedorak RN, Lukas M, MacIntosh D et al (2006) Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn’s disease: the CLASSIC-I trial. Gastroenterology 130:323–333
Nesbitt A, Fossati G, Bergin M, Stephens P, Stephens S, Foulkes R et al (2007) Mechanism of action of certolizumab pegol (CDP870): in vitro comparison with other anti-tumor necrosis factor alpha agents. Inflamm Bowel Dis 13:1323–1332
Monshouwer M, Witkamp RF, Nijmeijer SM, Van Amsterdam JG, Van Miert AS (1996) Suppression of cytochrome P450- and UDP glucuronosyl transferase-dependent enzyme activities by proinflammatory cytokines and possible role of nitric oxide in primary cultures of pig hepatocytes. Toxicol Appl Pharmacol 137:237–244
Maini RN, Breedveld FC, Kalden JR, Smolen JS, Davis D, Macfarlane JD et al (1998) Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor alpha monoclonal anti-body combined with low-dose weekly methotrexate in rheumatoid arthritis. Arthritis Rheum 41:1552–1563
Sandborn WJ, Feagan BG, Marano C, Zhang H, Strauss R, Johanns J, PURSUIT-Maintenance Study Group et al (2014) Subcutaneous golimumab induces clinical response and remission in patients with moderate-to-severe ulcerative colitis. Gastroenterology 146:85–95
Colombel JF, Sandborn WJ, Rutgeerts P, Enns R, Hanauer SB, Panaccione R et al (2007) Adalimumab for maintenance of clinical response and remission in patients with Crohn’s disease: the CHARM trial. Gastroenterology 132:52–65
Sandborn WJ, Reinisch W, Mantzaris GJ, Kornbluth A, Rachmilewitz D, SONIC Study Group et al (2010) Infliximab, azathioprine, or combination therapy for Crohn’s disease. N Engl J Med 362:1383–1395
Sandborn WJ, Schreiber S, Feagan BG, Rutgeerts P, Younes ZH, Bloomfield R et al (2011) Certolizumab pegol for active Crohn’s disease: a placebo-controlled, randomized trial. Clin Gastroenterol Hepatol 9(8):670–678
Ben-Horin S, Kopylov U, Chowers Y (2014) Optimizing anti-TNF treatments in inflammatory bowel disease. Autoimmun Rev 13(1):24–30
Sandborn WJ, Gasink C, Gao LL, Blank MA, Johanns J, Guzzo C, CERTIFI Study Group et al (2012) Ustekinumab induction and maintenance therapy in refractory Crohn’s disease. N Engl J Med 367(16):1519–1528
Zorzi F (2012) Efficacy and safety of infliximab and adalimumab in Crohn’s disease: a single centre study. Aliment Pharmacol Ther 35:1397–1407
Arnott ID, McNeill G, Satsangi J (2003) An analysis of factors influencing short-term and sustained response to infliximab treatment for Crohn’s disease. Aliment Pharmacol Ther 17:1451–1457
Sprakes MB, Ford AC, Warren L, Greer D, Hamlin J (2012) Efficacy, tolerability, and predictors of response to infliximab therapy for Crohn’s disease: a large single centre experience. J Crohns Colitis 6:143–153
Siegel CA, Melmed GY (2009) Predicting response to anti-TNF agents for the treatment of Crohn’s disease. Ther Adv Gastroenterol 2:244–251
Ferrante M, Vermeire S, Katsanos KH, Noman M, Van Assche G, Schnitzler F et al (2007) Predictors of early response to infliximab in patients with ulcerative colitis. Inflamm Bowel Dis 13:123–128
Lee KM, Jeen YT, Cho JY, Lee CK, Koo JS, Park DI et al (2013) Efficacy, safety, and predictors of response to infliximab therapy for ulcerative colitis: a Korean multicenter retrospective study. J Gastroenterol Hepatol 28:1829–1833
Sandborn WJ, Colombel JF, Panés J, Castillo M, Robinson AM, Zhou Q et al (2013) Exploring the use of adalimumab for patients with moderate Crohn’s disease: subanalyses from induction and maintenance trials. J Crohns Colitis 7:958–967
Steenholdt C, Palarasah Y, Bendtzen K, Teisner A, Brynskov J, Teisner B et al (2013) Pre-existing IgG antibodies cross-reacting with the Fab region of infliximab predict efficacy and safety of infliximab therapy in inflammatory bowel disease. Aliment Pharmacol Ther 37:1172–1183
Hlavaty T, Pierik M, Henckaerts L, Ferrante M, Joossens S, van Schuerbeek N et al (2005) Polymorphisms in apoptosis genes predict response to infliximab therapy in luminal and fistulizing Crohn’s disease. Aliment Pharmacol Ther 22:613–626
Arijs I, Quintens R, Van Lommel L, Van Steen K, De Hertogh G, Lemaire K et al (2010) Predictive value of epithelial gene expression profiles for response to infliximab in Crohn’s disease. Inflamm Bowel Dis 16:2090–2098
Arijs I, Li K, Toedter G, Quintens R, Van Lommel L, Van Steen K et al (2009) Mucosal gene signatures to predict response to infliximab in patients with ulcerative colitis. Gut 58:1612–1619
Van Moerkercke W et al (2010) High infliximab trough levels are associated with mucosal healing in Crohn’s disease. Gastroenterology 138(Suppl 1):S60
Zintzaras E, Dahabreh IJ, Giannouli S, Voulgarelis M, Moutsopoulos HM (2008) Infliximab and methotrexate in the treatment of rheumatoid arthritis: a systematic review and meta-analysis of dosage regimens. Clin Ther 30:1939–1955
Lin Z, Bai Y, Zheng P (2011) Meta-analysis: efficacy and safety of combination therapy of infliximab and immunosuppressives for Crohn’s disease. Eur J Gastroenterol Hepatol 23:1100–1110
Colombel JF, Feagan BG, Sandborn WJ, van Assche G, Robinson AM (2012) Therapeutic drug monitoring of biologics for inflammatory bowel disease. Inflamm Bowel Dis 18(2):349–358
Ben-Horin S, Chowers Y (2011) Loss of response to anti-TNF treatments in Crohn’s disease. Aliment Pharmacol Ther 33:987–995
St Clair EW, Wagner CL, Fasanmade AA, Wang B, Schaible T, Kavanaugh A et al (2002) The relationship of serum infliximab concentrations to clinical improvement in rheumatoid arthritis: results from ATTRACT, a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 46(6):1451–1459
Kopylov U, Mantzaris GJ, Katsanos KH, Reenaers C, Ellul P, Rahier JF et al (2011) The efficacy of shortening the dosing interval to once every six weeks in Crohn’s patients losing response to maintenance dose of infliximab. Aliment Pharmacol Ther 33(3):349–357
Katz L, Gisbert JP, Manoogian B, Lin K, Steenholdt C, Mantzaris GJ et al (2012) Doubling the infliximab dose versus halving the infusion intervals in Crohn’s disease patients with loss of response. Inflamm Bowel Dis 18:2026–2033
Ben-Bassat O, Hauestein S, Iacono A, Irwin SP, Singh S, Greenberg GR (2013) Serum adalimumab and immunogenicity in IBD patients after 80 mg biweekly maintenance therapy. Gastroenterology 144(Suppl 1):S771
Ma C, Panaccione R, Heitman SJ, Devlin SM, Ghosh S, Kaplan GG (2009) Systematic review: the short-term and long-term efficacy of adalimumab following discontinuation of infliximab. Aliment Pharmacol Ther 30(10):977–986
Afif W, Loftus EV, Faubion WA, Kane SV, Bruining DH, Hanson KA et al (2010) Clinical utility of measuring Infliximab and human anti-chimeric antibody concentrations in patients with inflammatory bowel disease. Am J Gastroenterol 105:1133–1139
Pariente B, Pineton de Chambrun G, Krzysiek R, Desroches M, Louis G, De Cassan C et al (2012) Trough levels and antibodies to infliximab may not predict response to intensification of infliximab therapy in patients with inflammatory bowel disease. Inflamm Bowel Dis 18:1199–1206
Van Assche G, Vermeire S, Rutgeerts P (2006) Safety issues with biological therapies for inflammatory bowel disease. Curr Opin Gastroenterol 22(4):370–376
Han PD, Cohen RD (2004) Managing immunogenic responses to infliximab: treatment implications for patients with Crohn’s disease. Drugs 64(16):1767–1777
Rutgeerts P, Van Assche G, Vermeire S (2006) Review article: Infliximab therapy for inflammatory bowel disease—seven years on. Aliment Pharmacol Ther 23(4):451–463
Feagan BG, Singh S, Lockton S, Hauenstein S, Ohrmund L, Croner LJ et al (2012) Novel infliximab and antibody-to-infliximab (ATI) assays are predictive of disease activity in patients with Crohn’s disease. Gastroenterology 142(Suppl 1):S–114
Karmiris K, Paintaud G, Noman M, Magdelaine-Beuzelin C, Ferrante M, Degenne D et al (2009) Influence of trough serum levels and immunogenicity on long-term outcome of adalimumab therapy in Crohn’s disease. Gastroenterology 137:1628–1640
Sandborn WJ, Hanauer SB, Pierre-Louis B, Lichtenstein GR (2012) Certolizumab pegol plasma concentration and clinical remission in Crohn’s disease. Gastroenterology 142(Suppl 1):S–563
Vande Casteele N, Compernolle G, Ballet V, Van Assche G, Gils A, Vermeire S et al (2012) Results on the optimisation phase of the prospective controlled Trough Level Adapted Infliximab Treatment (TAXIT) trial. Gastroenterology 142(Suppl 1):S211–S212
Ling J, Lyn S, Xu Z, Achira M, Bouman-Thio E, Shishido A et al (2010) Lack of racial differences in the pharmacokinetics of subcutaneous golimumab in healthy Japanese and Caucasian male subjects. J Clin Pharmacol 50:792–802
Zhuang Y, Lyn S, Lv Y, Xu Z, Bouman-Thio E, Masterson T et al (2013) Pharmacokinetics and safety of golimumab in healthy Chinese subjects following a single subcutaneous administration in a randomized phase I trial. Clin Drug Invest 33:795–800
Sandborn WJ, Feagan BG, Fedorak RN, Scherl E, Fleisher MR, Katz S et al (2008) A randomized trial of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with moderate-to-severe Crohn’s disease. Gastroenterology 135:1130–1141
Bridges LC, Tani PH, Hanson KR, Roberts CM, Judkins MB, Bowditch RD (2002) The lymphocyte metalloprotease MDC-L (ADAM 28) is a ligand for the integrin alpha4beta1. J Biol Chem 277:3784–3792
Li Z, Calzada MJ, Sipes JM, Cashel JA, Krutzsch HC, Annis DS et al (2002) Interactions of thrombospondins with alpha4beta1 integrin and CD47 differentially modulate T cell behavior. J Cell Biol 157:509–519
Bayless KJ, Davis GE (2001) Identification of dual alpha 4beta1 integrin binding sites within a 38 amino acid domain in the N-terminal thrombin fragment of human osteopontin. J Biol Chem 276:13483–13489
Sandborn WJ, Feagan BG, Rutgeerts P, Hanauer S, Colombel JF, Sands BE et al (2013) Vedolizumab as induction and maintenance therapy for Crohn’s disease. N Engl J Med 369:711–721
Yednock TA, Cannon C, Fritz LC, Sanchez-Madrid F, Steinman L, Karin N (1992) Prevention of experimental autoimmune encephalomyelitis by antibodies against alpha 4 beta 1 integrin. Nature 356:63–66
Polman CH, O’Connor PW, Havrdova E, Hutchinson M, Kappos L, Miller DH et al (2006) A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med 354:899–910
Rudick RA, Stuart WH, Calabresi PA, Confavreux C, Galetta SL, Radue EW et al (2006) Natalizumab plus interferon beta-1a for relapsing multiple sclerosis. N Engl J Med 354:911–923
Ghosh S, Goldin E, Gordon FH, Malchow HA, Rask-Madsen J, Rutgeerts P et al (2003) Natalizumab for active Crohn’s disease. N Engl J Med 348:24–32
Sandborn WJ, Colombel JF, Enns R, Feagan BG, Hanauer SB, Lawrance IC et al (2005) Natalizumab induction and maintenance therapy for Crohn’s disease. N Engl J Med 353:1912–1925
Targan SR, Feagan BG, Fedorak RN, Lashner BA, Panaccione R, Present DH et al (2007) Natalizumab for the treatment of active Crohn’s disease: results of the ENCORE trial. Gastroenterology 132:1672–1683
Sands BE, Kozarek R, Spainhour J, Barish CF, Becker S, Goldberg L et al (2007) Safety and tolerability of concurrent natalizumab treatment for patients with Crohn’s disease not in remission while receiving infliximab. Inflamm Bowel Dis 13:2–11
Feagan BG, Rutgeerts P, Sands BE, Hanauer S, Colombel JF, Sandborn WJ et al (2013) Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 369:699–710
Sandborn WJ, Feagan BG, Rutgeerts P, Hanauer S, Colombel JF, Sands BE et al (2013) Vedolizumab as induction and maintenance therapy for Crohn’s disease. N Engl J Med 369:711–721
Feagan BG, Greenberg GR, Wild G, Fedorak RN, Paré P, McDonald JW et al (2005) Treatment of ulcerative colitis with a humanized antibody to the alpha4beta7 integrin. N Engl J Med 352:2499–2507
Brunner M, Ziegler S, Di Stefano AF, Dehghanyar P, Kletter K, Tschurlovits M et al (2006) Gastrointestinal transit, release and plasma pharmacokinetics of a new oral budesonide formulation. Br J Clin Pharmacol 61:31–38
Acknowledgments
The authors would like to thank the invaluable help of Katrin Seemayer (Grünenthal Information Management Services) for her contribution to the scientific information, criticism of the manuscript and subsequent corrections.
Conflict of interest
Emilio G. Quetglas, Simone Wigge, Lutz Barnscheid and Marcel Froelich are currently employees of Grünenthal. Alessandro Armuzzi has been an External Consultant for AbbVie, Lilly, Hospira, MSD, Mundipharma, Pfizer, Sofar and Takeda and a lecturer for AbbVie, AstraZeneca, Chiesi, Ferring, Hospira, MSD, Otsuka, Takeda and Zambon. He also holds a grant for research from MSD. Gionata Fiorino served as a consultant and a member of Advisory Boards for MSD, AbbVie, Takeda Pharmaceuticals and Janssen Pharmaceuticals. Silvio Danese has served as a speaker, consultant and Advisory Board member for Schering-Plough, Abbott Laboratories, Merck & Co, UCB Pharma, Ferring, Cellerix, Millenium Takeda, Nycomed, Pharmacosmos, Actelion, Alpha Wasserman, Genentech, Grünenthal, Pfizer, AstraZeneca, Novo Nordisk, Cosmo Pharmaceuticals, Vifor Pharma and Johnson & Johnson.
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Quetglas, E.G., Armuzzi, A., Wigge, S. et al. Review article: The pharmacokinetics and pharmacodynamics of drugs used in inflammatory bowel disease treatment. Eur J Clin Pharmacol 71, 773–799 (2015). https://doi.org/10.1007/s00228-015-1862-7
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DOI: https://doi.org/10.1007/s00228-015-1862-7