Maintaining efficacy of infliximab in Crohn's disease

A study in the latest Inflammatory Bowel Disease correlates retrieval of serum infliximab level by shortening the maintenance infusion interval with clinical efficacy in Crohn's disease.

Infliximab has shown beneficial effects in the treatment of Crohn's disease (CD).

Dr Toshifumi Hibi and colleagues from Japan assessed the clinical efficacy of shortening the infusion interval from 8 to 4 weeks when patients had shown loss of response during maintenance therapy, and the association between the serum trough level and clinical efficacy.

The researchers performed an open-label prospective multicenter study.

Infliximab was administered at 5 mg/kg to patients with active CD at weeks 0, 2, and 6.

Week 10 responders received infliximab every 8 weeks thereafter.

The overall clinical response rate at week 54 was 83%

Inflammatory Bowel Disease

In those with loss of response after week 14 the interval was switched to every 4 weeks.

Co-primary endpoints were the rate of patients achieving clinical response and remission at week 54. Serum level of infliximab was measured at each visit.

The researchers reported that 57 patients who responded to induction treatment received maintenance therapy after week 14.

The team noted that 37 patients continued at the 8-week interval and 20 patients were switched to a 4-week interval.

The overall clinical response and remission rates at week 54 were 83% and 61%, respectively.

For those with loss of response, treatment at the 4-week interval resulted in clinical response and remission rates of 83% and 56%, respectively, at week 54.

The team found a correlation between clinical efficacy and serum trough level.

Dr Hibi's team concluded, "A treatment strategy with an option of shortening the dosing interval of infliximab retrieves its trough level and may be useful for maintaining its efficacy."