Infliximab dose intensification by shortening infusion intervals

Durability of Infliximab Dose Intensification in Crohn’s Disease

“…Among patients who lost response to infliximab after receiving at least eight infusions, Regueiro et al [12] reported regaining response in 76% after either dose doubling or increase in infusion frequency. A smaller retrospective study by Magro et al [13] focused exclusively on shortening infusion intervals in CD patients with loss of response to infliximab and found that therapeutic benefit could be regained by increasing the frequency of infusions from every 8 weeks to every 6 weeks. Recently, a European multicenter study by Kopylov et al [14] confirmed the efficacy of 6-week infusion intervals in comparison with double dosing (10 mg/kg/8 weeks or 5 mg/kg/4 weeks).…”

“…A similar investigation has emerged in the Crohn's disease literature and suggests that waning response to infliximab may be effectively overcome by either doubling the infusion dose from 5 to 10 mg/kg, or by delivering infusions more frequently than the conventional every-8-week schedule. Initial response rates to dose intensification have been reported between 76 and 90% [1,[10][11][12][13].…”

The efficacy of shortening the dosing interval to once every six weeks in Crohn’s patients losing response to maintenance dose of infliximab

“…Magro et al. 9 found that shortening the dosing interval to 6 weeks was an efficient strategy for managing LOR in CD patients receiving maintenance treatment with infliximab. However, this was a small‐scale retrospective study that included only 15 patients.…”

“…A study by Seow et al 10 in patients receiving maintenance infliximab therapy for ulcerative colitis demonstrated that in patients who had lost response to 5 mg ⁄ kg of infliximab every 8 weeks, shortening of the dosing interval to 6-7 weeks resulted in regained remission in 44% of the patients, whereas doubling the dose resulted in regained remission in 25% of the patients, but the duration of the regained remission was not reported. Magro et al 9 found that shortening the dosing interval to 6 weeks was an efficient strategy for managing LOR in CD patients receiving maintenance treatment with infliximab. However, this was a small-scale retrospective study that included only 15 patients.…”

“…In the ACCENT 1 trial, this double‐dosing policy has lead to regained response in 80–90% of patients 1 . However, rather than double‐dosing, many physicians reduce the dosing interval to 6 weeks in those patients who experience a shortened duration of response 9 . Although this approach may be less costly and could be more convenient for the patients, requiring clinic visit every 6 weeks instead of every 4 weeks, there are sparse data to support this clinical practice or its efficacy.…”