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Infliximab maintenance therapy for Crohn's disease is administered every 8 weeks, but inter-patient variation in optimal treatment intervals may exist.
Dr Munkholm and colleagues from Denmark performed a prospective pilot study to assess the efficacy, safety and quality of life of infliximab maintenance treatment scheduled through web-based self-monitoring of disease activity.
The team enrolled 27 Crohn's disease patients in infliximab maintenance therapy, and received a standardized disease education and web-training. Using the http://www.cd.constant-care.dk concept, patients recorded their disease activity and fecal calprotectin weekly. From this, the inflammatory burden score was calculated, placing patients in the green, yellow or red zones of a ‘traffic light’ system.  | | Only 10% of infusions were given at 8-week intervals | | Alimentary Pharmacology & Therapeutics |
If placed in the yellow or red zones, the computer directed these patients to consult their physician for ifliximab infusion.
The researchers found that 63% completed 52 weeks of follow-up, 22% completed 26 weeks, and 15% were excluded due to loss of response, patient decision or non-adherence. In total, 121 infliximab infusions were given with a median interval of 9 weeks. Only 10% of infusions were given at 8-week intervals, whereas 39% were administered with shorter, and 50% with longer intervals respectively. The research team observed that the mean inflammatory burden, and the quality of life remained stable during the web-treatment. The team found that 1 mild infusion reaction and one case of folliculitis were observed, while 3 patients underwent surgery.
Dr Munkholm's team concluded, "The program http://www.cd.constant-care.dk appears to be a practical and safe concept for the individualised scheduling of maintenance treatment with infliximab in patients with Crohn's disease." "Larger studies are awaited to confirm this preliminary outcome."
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