The efficacy of shortening the dosing interval to once every six weeks in Crohn's patients losing response to maintenance dose of infliximab (Journal article)

Kopylov, U./ Mantzaris, G. J./ Katsanos, K. H./ Reenaers, C./ Ellul, P./ Rahier, J. F./ Israeli, E./ Lakatos, P. L./ Fiorino, G./ Cesarini, M./ Tsianos, E. V./ Louis, E./ Ben-Horin, S.

BACKGROUND: Patients treated with infliximab for Crohn's disease (CD) frequently require intensified dosage due to loss of response. There are scant data regarding the efficacy of shortening the dosing interval to 6 weeks. AIM: We sought to investigate the efficacy of a once every 6 weeks' strategy compared with dose-doubling. METHODS: This work was a multicentre retrospective study of infliximab-treated CD patients who required dose escalation. The clinical outcome of patients treated by intensification to 5 mg/kg/6 weeks (6-week group) was compared with the outcome of patients whose infliximab was double-dosed (10 mg/kg/8 weeks or 5 mg/kg/4 weeks). RESULTS: Ninety-four patients (mean age: 29.8 years) were included in the study, 55 (59%) in the 6-week group and 39 (41%) in the double-dose group. Demographics and disease characteristics were similar between the two groups, although patients with re-emerging symptoms 5-7 weeks postinfusion were more likely to receive 5 mg/kg/6 weeks dosing (OR: 3.4, 95% CI: 1.4-8.8, P < 0.01). Early response to dose-intensification occurred in 69% of patients in the 6-week group and 67% in the double-dose group (P = N.S.). Regained response was maintained for 12 months in 40% compared with 29% of the patients respectively (P = N.S.). CONCLUSION: In CD patients who lost response to standard infliximab dose, especially when symptoms re-emerge 5-7 weeks postinfusion, shortening the dosing interval to 6 weeks appears to be at least as effective as doubling the dose to 10 mg/kg or halving the infusion intervals to once in 4 weeks.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Adult,Antibodies, Monoclonal/*administration & dosage,Crohn Disease/*drug therapy,Dose-Response Relationship, Drug,Female,Gastrointestinal Agents/*administration & dosage,Humans,Male,Retrospective Studies,Statistics as Topic,Time Factors,Treatment Outcome,Young Adult
URI: https://olympias.lib.uoi.gr/jspui/handle/123456789/24503
ISSN: 1365-2036
Link: http://www.ncbi.nlm.nih.gov/pubmed/21118397
http://onlinelibrary.wiley.com/store/10.1111/j.1365-2036.2010.04523.x/asset/j.1365-2036.2010.04523.x.pdf?v=1&t=h0tasl6y&s=c80a19faa37e1b5b17ceb51ef2f716bfe2942940
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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