Abstract
Objective: Infliximab (IFX), a monoclonal antibody against tumor necrosis factorα (TNF-α), has been used for the treatment of rheumatoid arthritis (RA). However, some patients report a decrease in the effectiveness of IFX therapy during the course of the treatment. In July 2009, dose escalations and interval shortening of IFX infusion were approved in daily practice. We evaluated cases that required IFX dose escalation and/or interval shortening.
Material and Method: We selected 124 patients (23 men and 101 women; median age, 56 years; age range, 24-81 years) who were treated with IFX for RA. The median of the total number of IFX infusions received was 17 (range, 4-51 times). We evaluated the cases that required dose escalation and/or interval shortening of IFX infusion.
Results: Of the 124 cases, 42 cases (33.9％) required dose escalation and/or interval shortening. Of these 42 cases, 14 required dose escalation; 15, interval shortening; and 13, both dose escalation and interval shortening. No serious adverse events were observed in any case. Despite these measures, 8 cases did not respond well.
Conclusion: IFX dose escalation and/or interval shortening were carried out in patients in whom IFX treatment was less effective. A recovery of the effectiveness of IFX treatment was observed in 33 of the 42 cases (78.6％). Therefore, dose escalation and/or interval shortening are effective procedures in patients in whom a reduction in the effectiveness of IFX treatment is observed.
