Please use this identifier to cite or link to this item:
https://www.um.edu.mt/library/oar/handle/123456789/121370
Title: | Doubling the infliximab dose versus halving the infusion intervals in Crohn's disease patients with loss of response |
Authors: | Katz, Lior Gisbert, Javier P. Manoogian, Beth Lin, Kirk Steenholdt, Casper Mantzaris, Gerassimos J. Atreja, Ashish Ron, Yulia Swaminath, Arun Shah, Somal Hart, Ailsa Lakatos, Peter Laszlo Ellul, Pierre Israeli, Eran Svendsen, Mads Naundrup van der Woude, C. Janneke Katsanos, Konstantinos H. Yun, Laura Tsianos, Epameinondas V. Nathan, Torben Abreu, Maria Dotan, Iris Lashner, Bret Brynskov, Jorn Terdiman, Jonathan P. Higgins, Peter D.R Chaparro, Maria Ben-Horin, Shomron |
Keywords: | Inflammatory bowel diseases Crohn's disease Ulcerative colitis Infliximab Immunosuppressive agents |
Issue Date: | 2012 |
Publisher: | Wiley Online Library |
Citation: | Katz, L., Gisbert, J. P., Manoogian, B., Lin, K., Steenholdt, C., Mantzaris, G. J.,...Ben‐Horin, S. (2012). Doubling the infliximab dose versus halving the infusion intervals in Crohn's disease patients with loss of response. Inflammatory bowel diseases, 18(11), 2026-2033. |
Abstract: | Background: Intensifying infliximab therapy is often practiced in Crohn’s disease (CD) patients losing response to the drug but there are no data if halving the interval is superior to doubling the dose. We aimed to assess the efficacy of infliximab dose intensification by interval-halving compared with dose-doubling. Methods: A multicenter retrospective study of CD patients losing response to infliximab was undertaken. The clinical outcome of patients whose infusion intervals were halved (5 mg/kg/4 weeks) was compared with patients treated by dose-doubling (10 mg/kg/8 weeks). Results: In all, 168 patients were included from 18 centers in Europe, USA, and Israel. Of these, 112 were intensified by dose-doubling and 56 received interval-halving strategy. Early response to dose-escalation was experienced by 86/112 (77%) patients in the dose-doubling group com pared with 37/56 patients (66%) in the interval-halving group (odds ratio [OR] 1.7, 95% confidence interval [CI] 0.8–3.4, P ¼ 0.14). Sustained clinical response at 12 months postescalation was maintained in 50% of patients in the dose-doubling group compared with 39% in the interval-halving group (OR 1.5, 95% CI 0.8–2.9, P ¼ 0.2). On multivariate analysis, predictors of long-term response to escalation were a nonsmoking status, CD diagnosis between 16–40 years of age, and normal C-reactive protein (CRP). Conclusions: Dose intensification leads to a sustained regained response in 47% of CD patients who lost response to standard infliximab dose, but halving the infusion intervals is probably not superior to dose-doubling. Given the costs and patient inconvenience incurred by an additional infusion visit, the dose-doubling strategy may be preferable to the interval-halving strategy. |
URI: | https://www.um.edu.mt/library/oar/handle/123456789/121370 |
Appears in Collections: | Scholarly Works - FacM&SMed |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
Doubling_the_infliximab_dose_versus_halving_the_infusion_intervals_in_Crohns_disease_patients_with_loss_of_response_2012.pdf Restricted Access | 902.98 kB | Adobe PDF | View/Open Request a copy |
Items in OAR@UM are protected by copyright, with all rights reserved, unless otherwise indicated.