P352 Need for infliximab dose intensification in patients with Crohn's disease and ulcerative colitis

Cultured blood T‐cell responses predict anti‐TNF therapy response in patients with ulcerative colitis

“…Factors influencing the response rate may be the criteria set for therapy response as well as the time point when response was defined, which was week 8 for ACT1 and 2 and ULTRA 2 and week 12–14 in this study . In the later studies, dose escalation in patients not achieving response and in the need for intensified anti‐TNF treatment was undertaken in 42% and 50% . Importantly, the response rates in the exploratory and validation cohorts in our study were similar and the 1‐year follow‐up response rate (42%) for the exploratory cohort correlates with ACT1 (46%) .…”

Infliximab Dose Escalation as an Effective Strategy for Managing Secondary Loss of Response in Ulcerative Colitis

“…Evidence from uncontrolled retrospective studies regarding the results of infliximab dose escalation in UC is also scarce [3,9,14]. Surprisingly, despite the lack of good quality evidence, in clinical practice the rate of patients who have had infliximab dose escalation seems to be higher in UC [2][3][4][5][6][7][8][9][10] compared to CD [12]. The present study represents the largest cohort on the outcomes of infliximab dose escalation in UC patients reported to date.…”

“…As an example, the pivotal active ulcerative colitis (ACT) trials did not allow infliximab dose escalation on loss of response during maintenance [1]. Despite the lack of good quality evidence for infliximab dose intensification in UC, a number of studies have reported high rates of therapy escalation in UC [2][3][4][5][6][7][8][9][10].…”

Frequency, predictors, and consequences of maintenance infliximab therapy intensification in ulcerative colitis

“…This intensification rate is much lower than shown in other studies (1,3,6,(10)(11)(12). In the study by Ferrante et al nearly 40% of the 73 patients on maintenance with IFX were intensified (10), and a Spanish study also shows an intensification rate of 40% in the setting of UC (3).…”

“…The standard regimen for maintenance consists of 5 mg/kg every 8 weeks, but the need for dose increases or dose interval shortening as shown by pivotal studies (2) is lower than in clinical practice or real-world studies (3,4). Intensification is usually effective for IFX response recovery, thus avoiding therapy changes or colectomy (5)(6)(7)(8), but has an impact on treatment cost (3) and perhaps patient safety.…”