Low-dose infliximab treatment for ankylosing spondylitis - clinically- and cost-effective

Jois, R. N., Leeder, L., Gibb, A., Gaffney, K. ORCID: https://orcid.org/0000-0002-7863-9176, MacGregor, A. J. ORCID: https://orcid.org/0000-0003-2163-2325, Somerville, M. and Scott, D. G. I. (2006) Low-dose infliximab treatment for ankylosing spondylitis - clinically- and cost-effective. Rheumatology, 45 (12). pp. 1566-1569. ISSN 1462-0332

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Abstract

Objectives: Infliximab has been shown to be effective in the treatment of ankylosing spondylitis (AS) when treated in a dose of 5 mg/kg at 6 weekly intervals. This dose of infliximab has not been determined by any structured randomized trials and has significant cost implications. We describe our experience of treating AS with low-dose infliximab (3mg/kg at 8 weekly intervals). The efficacy and cost implications are discussed. Methods: Patients who had active AS [Bath AS Disease Activity Index (BASDAI)≥ 4] were treated with infliximab 3 mg/kg at 0, 2, 6 weeks and thereafter at 8 weekly intervals. Response to treatment was defined as 50% improvement in BASDAI. Other response criteria such as ASAS 20, 40 and five of the six criteria were also assessed. Direct drug costs for infliximab were determined. Results: Twenty-two consecutive AS patients received infliximab. All 22 completed treatment for 3 months, 15 patients for 6 months and 14 for 12 months. Mean age was 45 years (range 21–62) and mean disease duration 14.5 years (range 2–43). Of the patients, 54% achieved a 50% BASDAI response at 3 months and the benefit was sustained at 12 months in 63%. Similar response rate was seen with the other assessment criteria. Direct drug costs were significantly lower when low-dose infliximab regimen was used. Conclusions: Low-dose infliximab (3 mg/kg at 8 weekly infusions) is effective in the treatment of AS. Higher doses are required in a small proportion of patients when treatment is only partially effective. Titrating the dose and frequency of infusions may be required in individual patients to achieve optimal response. Using low-dose infliximab has significant economic implications.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School


UEA Research Groups: Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine
Faculty of Medicine and Health Sciences > Research Groups > Musculoskeletal Medicine
Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Depositing User: EPrints Services
Date Deposited: 25 Nov 2010 11:10
Last Modified: 17 Jul 2024 14:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/12987
DOI: 10.1093/rheumatology/kel156

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