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News

Infliximab treatment via self-managed web-based solution in Crohn's

The most recent issue of the Alimentary Pharmacology & Therapeutics examines the individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn's disease.

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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."

Aliment Pharmacol Ther 2012: 36(9): 840–849
09 October 2012

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