DOP085 Success rate of dose de-escalation in patients with inflammatory bowel disease treated with intensified anti-TNF therapy
2014
achieve therapeutic levels. By delivering IFX at shorter intervals during induction, higher trough levels could be achieved, and patients could be successfully treated medically without the need for colectomy. Methods: Retrospective analysis of a prospectively maintained database of patients with IBD (n = 3,200). Patients who required hospitalisation and were given rescue infliximab for acute severe colitis from June 2005-September 2013 at a single academic centre were identified. In 2011 an accelerated dosing protocol for IFX was introduced. Patients given standard dosing (SD) received infliximab at time 0, 2, and 6 weeks and 8 weekly thereafter. Patients given accelerated dosing (AD) received all three induction doses of IFX within 2 weeks and 8 weekly thereafter. Rates of colectomy were compared between the 2 groups at 3, 6 and 12 months. Results: 52 patients received infliximab; 38 received SD and 14 received AD. There were no differences in median CRP (SD = 54, AD = 38 p = 0.4), median albumin (SD = 23, AD = 22.5, p = 0.64), median platelet count (SD = 390, AD = 414, p = 0.84), median haemoglobin (11.0 SD, 10.5 AD p = 0.76) or median disease duration (SD = 11.8 years, AD = 5.3 years, p = 0.47) between the 2 groups on the day of induction.
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