title: Increasing the infliximab dose is beneficial in Crohn's disease patients who responded to a lower dose and relapsed.
abstract: BACKGROUND
  Relapse after an initial response to infliximab therapy poses a problem for maintenance treatment.
  
  
  OBJECTIVE
  To assess the effects of increasing the infliximab dosage in Crohn's disease (CD) patients who initially responded but flared during maintenance therapy.
  
  
  METHODS
  This was an observational study. Twelve CD patients with both inflammatory and fistulizing manifestations were included. All patients initially responded to 5 mg/kg of infliximab, relapsed during maintenance therapy, and were treated with 10 mg/kg. The Harvey-Bradshaw index, the fistula activity, and steroid use were assessed before and after treatment with the increased dose of infliximab.
  
  
  RESULTS
  The mean Harvey-Bradshaw index score after flare-up during treatment with 5 mg/kg of infliximab was 13.5+/-3.7. Treatment with 10 mg/kg, in a mean of 3.3 infusions, decreased the activity score to a mean of 8.8+/-2.5. Two patients were weaned off prednisone, and a reduced dose was possible in the other steroid-treated patients.
  
  
  CONCLUSIONS
  Increasing the infliximab dose may be beneficial in CD patients who initially responded to therapy, but relapsed during maintenance with the lower dosage.
authors.affiliation: Department of Gastroenterology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Menachem
authors.forename: Benjamin
authors.initials: B
authors.lastname: Avidan
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lavy
authors.forename: Alon
authors.initials: A
authors.lastname: Lang
authors.forename: Eytan
authors.initials: E
authors.lastname: Bardan
authors.forename: Herma
authors.initials: H
authors.lastname: Fidder
authors.forename: Simon
authors.initials: S
authors.lastname: Bar-Meir
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Chowers
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D003424:Crohn Disease / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab