title: A 3 mg/kg starting dose of infliximab in active spondyloarthritis resistant to conventional treatments is efficient, safe and lowers costs.
abstract: OBJECTIVE
  We assessed the efficacy, tolerance and cost of a 3 mg/kg starting dose of infliximab for ankylosing spondylitis (AS) and psoriatic arthritis (PsA).
  
  
  METHODS
  We retrospectively followed-up 45 biologic-naive consecutive patients (11 with axial AS, 24 with axial and peripheral [mixed] AS and 10 with PsA) who were treated between 2002 and 2005 with a 3 mg/kg dose of infliximab after failure of conventional therapies. The following variables were recorded: visual analog scale (VAS) scores of patient's global (G) and pain (P) assessment, duration of early morning stiffness (EMS), disease activity (BASDAI) and functional disability (BASFI). Treatment responses were assessed at 6 and 12 months using the AS assessment score (ASAS)-20% and -40% criteria and BASDAI-50.
  
  
  RESULTS
  Baseline characteristics of the 29 men and 16 women were (median [range]): G-VAS, 70 [13-100]; P-VAS, 70 [13-100]; EMS, 60 [0-180] minutes; BASDAI, 64.4 [23.9-100]; BASFI, 57.2 [3.5-98.5]. All manifestations regressed significantly (p<0.0001) for 39 (86.7%) and 24 (53.5%) patients at 6 and 12 months, respectively; 26 (57.8%) had achieved ASAS-20 responses at 6 months that persisted at 1 year for 20 (44.4%); 19 (42.2%) and 12 (26.7%) satisfied BASDAI 50 criteria at 6 and 12 months, respectively. Interestingly, almost 30% still received low-dose infliximab after 4 years of follow-up.
  
  
  CONCLUSIONS
  An initial dose of 3 mg/kg of infliximab significantly attenuated AS and PsA manifestations in>40% of the patients, making use of this dose highly advantageous in terms of safety and 33% lower cost.
authors.affiliation: Department of Pharmacy, Rouen University Hospital, 76031 Rouen cedex, France.
authors.forename: Ginette
authors.initials: G
authors.lastname: Tenga
authors.forename: Vincent
authors.initials: V
authors.lastname: Goëb
authors.forename: Thierry
authors.initials: T
authors.lastname: Lequerré
authors.forename: Hélène
authors.initials: H
authors.lastname: Bacquet-Deschryver
authors.forename: Alain
authors.initials: A
authors.lastname: Daragon
authors.forename: Sophie
authors.initials: S
authors.lastname: Pouplin
authors.forename: Karine
authors.initials: K
authors.lastname: Lanfant-Weybel
authors.forename: Xavier
authors.initials: X
authors.lastname: Le Loët
authors.forename: Bernard
authors.initials: B
authors.lastname: Dieu
authors.forename: Olivier
authors.initials: O
authors.lastname: Vittecoq
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000191:economics; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000191:economics; D015535:Arthritis, Psoriatic / Q000188:drug therapy / Q000191:economics; D017046:Cost Savings; D004305:Dose-Response Relationship, Drug; D016527:Drug Costs; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000191:economics*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000069285:Infliximab