Abstract
Background: The validity and safety in high-dose infliximab (IFX) medication for patients with rheumatoid arthritis (RA) were shown by the RISING study. However, there are few reports using the dose-escalation IFX method according to disease activity.
Methods: We established a dose-escalation IFX protocol for RA, and have treated patients with RA according to this protocol since2009. The efficacy and safety were retrospectively compared with a historical control protocol with dose-fixed IFX.
Results: Nineteen patients were treated with the dose-escalation IFX protocol (dose-escalation group) and their outcomes were compared with those of 22historical controls treated with the dose-fixed IFX protocol (control group). No significant differences were found in the backgrounds between the groups. Since there were no early discontinuations due to poor response to IFX among the dose-escalation group, the rate of IFX continuation was increased in doseescalation group. The remission rates of the dose-escalation group, using the measures of DAS28＜2.6, SDAI≦3.3 and CDAI≦2.8, were significantly improved compared to those of control group (p＜0.05, chi-square test). The incidence rates of adverse events between these groups were not significantly different during the follow-up periods.
Conclusion: The dose-escalation IFX therapy was well tolerated for RA and contributed to better remission induction.
