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Infliximab activity and neutralizing Ab

Lab Section:  Sendout Reference  
Lab Location:  Sendout
Reference Lab: ARUP 
Test ID: LAB7154 
Methodology: Cell Culture/ Cell function assay involving cell stimulation /Quantitative Chemiluminescent Immunoassay/ Semi-Quantitative Chemiluminescent Immunoassay
Schedule: Mon-Fridays
Reported: 5 days
Specimen Requirements:  Collection: 3.0 mL Blood in a Gold Top Tube.
Pediatric volume: 1 mL.
Collect specimens before infliximab treatment.
Transport: Refrigerated.
Unacceptable conditions: Contaminated, hemolyzed, icteric, or lipemic specimens.
Stability: After separation from cells: Ambient: 48 hours; Refrigerated: 4 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)

Notes: 

Clinical Indications: This test measures the capacity of infliximab to neutralize TNF-activity. Additionally, infliximab neutralizing antibodies (NAb) are titered (reporting the highest dilution of patient sera in which NAb activity is detected). This test is used to evaluate secondary response failures to infliximab therapy. Secondary response failure is defined as loss of clinical response after initial improvement of clinical signs and symptoms. Therapeutic decision should rest on both the clinical response and the knowledge of the fate of the drug including the emergence of immunogenicity in individual patients. Circulating infliximab levels have been shown to vary considerably between patients. These differences relate to route and frequency of administration and patient-related features such as age, gender, weight, drug metabolism, and concomitant medications such as methotrexate and other immunosuppressants.

Reference Interval:  See patient report or consult reference laboratory website.
CPT Code(s): 86352x2
Last Changed: 11/11/2016 13:46:03
Last Reviewed: 12/27/2016 00:04:24