Infliximab: study identifies optimal starting dose for hidradenitis suppurativa

Takeaway

• A small retrospective study concludes that 10 mg/kg of infliximab (Remicade) every 6 or 8 weeks may by a reasonable starting dose for most patients with hidradenitis suppurativa (HS).

Why this matters

• Although dose titration is often required to optimize treatment response, few studies have addressed optimal infliximab dosing for HS.

Key results

• Patients were on infliximab for an average of 54.4 (range, 3-142) weeks.
• The most common initial regimens were 10 mg/kg every 8 weeks (69%) and 7.5 mg/kg every 8 weeks (19%).
• The most common ongoing regimens at data collection were 10 mg/kg every 8 weeks (33%) and 10 mg/kg every 6 weeks (27%).
  • 19% of patients had discontinued.
• 67% of patients achieved stable dosing:
  • 77% of these were at a schedule of 10 mg/kg every 6 or 8 weeks.
  • Achievement of stable dosing was not associated with initial dose (P=.94) or final dose (P=.25).
• 64% of patients required dose escalation 1 year from initiation.
• 19% of patients experienced adverse events.

Study design

• Study of 52 patients with HS receiving infliximab.
• Funding: None.

Limitations

• Retrospective study.
• Small patient sample size.
• Many patients lacked HS clinical response data.