To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Flexible Dosing of Infliximab Ensures Long-Term Response in Crohn's Disease: Presented at UEGW URL: http://www.pslgroup.com/dg/231552.htm Doctor's Guide October 24, 2008
By Judith Moser, MD VIENNA, Austria -- October 23, 2008 -- Approximately half of patients with Crohn's disease under maintenance treatment with infliximab require therapeutic intervention to control their disease over the course of 5 years, researchers noted here at the 16th United European Gastroenterology Week (UEGW). These interventions are mostly successful, however, and only one-fifth of initial responders in a recent study had to discontinue their treatment due to loss of response, explained Fabian Schnitzler, MD, University Hospital Gasthuisberg, Leuven, Belgium. "The aim of the study was to assess the magnitude of loss of response in clinical practice in the long-term treatment of Crohn's disease with infliximab and to evaluate the flexibility of the infliximab therapy to maintain clinical response," Dr. Schnitzler noted in his presentation on October 22. Interventions necessary to keep the disease under long-term control included shortening the administration intervals, increasing the doses of infliximab (up to a maximum of 10 mg/kg), or changing from episodic to scheduled treatment with infliximab infusions every 8 weeks. After 614 patients were recruited, 67 were excluded early due to a lack of clinical benefit. Among the remaining 547 patients, 35.5% received scheduled treatment from the start and 64.5% received episodic treatment in the beginning. Of the latter, 29.8% of patients switched to scheduled treatment after a median of 6 infusions, and 34.7% of patients stayed on episodic treatment until the end of the follow-up. The median follow-up was 55 months. Within the initial group of 547 responders, 58% lost response to infliximab in the long run. Of these patients who lost response, 13.6% could not be rescued with any intervention and therefore had to stop infliximab treatment. Of initial responders who lost response, 86.4% underwent intervention. In these patients, intervention was successful in 72.6%; the 27.4% in whom intervention was unsuccessful had to stop infliximab. Overall, 118 (21.6%) of the initial responders had to discontinue infliximab due to loss of response, Dr. Schnitzler said. This group comprised the 43 patients (13.6%) who could not be rescued with any intervention in the first place and the 75 patients (27.4%) who underwent unsuccessful intervention. Dr. Schnitzler explained that those who received scheduled treatment from the start experienced a significantly lower need for interventions compared with those receiving episodic treatment. The switch from episodic to scheduled treatment was the most common intervention, followed by increased dose and shortening of the administration interval. More than half of the patients who lost response with need for discontinuation could be successfully switched to humanised or human anti-tumour necrosis factor (TNF) therapy. Surgery became necessary in 27%. Approximately 30% to 50% of patients with Crohn's disease who receive maintenance therapy with infliximab will lose their response in the course of 1 year, but a premature switch to another anti-TNF should be avoided, Dr. Schnitzler emphasised. "Flexibility in both the dose and the interval may be an easy way to keep the disease under control in the long run," he stated. [Presentation title: Flexible Dosing of Infliximab Enables Long-Term Maintenance of Response in Patients With Refractory Crohn's Disease. Abstract 300] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.