High-dose, high-frequency infliximab: A novel treatment paradigm for hidradenitis suppurativa.

Autor: Ghias MH; Division of Dermatology, Department of Internal Medicine, Albert Einstein College of Medicine, Bronx, New York., Johnston AD; Division of Dermatology, Department of Internal Medicine, Albert Einstein College of Medicine, Bronx, New York., Kutner AJ; Division of Dermatology, Department of Internal Medicine, Albert Einstein College of Medicine, Bronx, New York., Micheletti RG; Departments of Dermatology and Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Hosgood HD; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York., Cohen SR; Division of Dermatology, Department of Internal Medicine, Albert Einstein College of Medicine, Bronx, New York. Electronic address: srcohen@montefiore.org.
Jazyk: angličtina
Zdroj: Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2020 May; Vol. 82 (5), pp. 1094-1101. Date of Electronic Publication: 2019 Oct 04.
DOI: 10.1016/j.jaad.2019.09.071
Abstrakt: Background: The permanent disfigurement associated with hidradenitis suppurativa (HS) necessitates early aggressive disease intervention. Although limited data support the use of infliximab (IFX) in HS, the efficacy of high-dose, high-frequency IFX has yet to be defined.
Objective: To evaluate the efficacy of IFX 7.5 to 10 mg/kg, with a maintenance frequency every 4 weeks.
Methods: Prospective analysis of 42 patients initiating IFX 7.5 mg/kg every 4 weeks (IFX 7.5) and 16 patients receiving dose escalation to IFX 10 mg/kg every 4 weeks (IFX 10) between March 1, 2018, and February 28, 2019. The primary outcome measure (clinical response) was the proportion of patients with Physician Global Assessment of clear, minimal, or mild (score of 0-2) HS with at least a 2-grade improvement from baseline scores.
Results: The proportion of patients achieving a clinical response after initiating IFX 7.5 was 20 of 42 (47.6%) at week 4 and 17 of 24 (70.8%) at week 12. For patients receiving dose escalation to IFX 10 because of incomplete initial response, 6 of 16 (37.5%) achieved clinical response at week 4 and 6 of 12 (50%) at week 12.
Conclusions: Initiation of IFX 7.5 every 4 weeks, with possible dose escalation to IFX 10, if needed, provides optimal mitigation of HS-related disease activity.
(Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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