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Rheumatology Advance Access originally published online on August 23, 2005
Rheumatology 2005 44(12):1555-1558; doi:10.1093/rheumatology/kei085
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Effectiveness of reducing infliximab dose interval in non-responder patients with refractory spondyloarthropathies. An open extension of a multicentre study

E. Collantes-Estevez, M. C. Muñoz-Villanueva, P. Zarco1, J. C. Torre-Alonso2, J. Gratacós3, C. González4, R. Sanmartí5, J. D. Cañete5 and (Spanish Spondyloarthropathies Study Group)

Department of Rheumatology, Reina Sofia University Hospital of Córdoba, Córdoba, 1 Department of Rheumatology, Fundación Hospital of Alcorcón, Madrid, 2 Department of Rheumatology, Monte Naranco Hospital, Oviedo, 3 Department of Rheumatology, Parc Taulí Hospital, Sabadell, 4 Department of Rheumatology, Gregorio Marañón University Hospital, Madrid and 5 Department of Rheumatology, Clinic Hospital of Barcelona, Barcelona, Spain.

Correspondence to: E. Collantes-Estevez, Department of Rheumatology, Hospital Universitario Reina Sofía, Menendez Pidal, s/n, 14004, Cordoba, Spain. E-mail: ecollantes{at}ctv.es

Objective. To evaluate the therapeutic effectiveness of reducing the infliximab dose interval to 6 weeks in spondyloarthropathy patients not responding to 5 mg/kg every 8 weeks.

Methods. After 30 weeks of infliximab therapy, 25 patients were classified as responders [Bath Ankylosing Spondylitis Activity Index (BASDAI) <4 cm or ESR <30 mm/h and CRP <5 mg/l, n=15; group A] or non-responders (patients who did not achieve the response established for group A; n=10; group B). Responders continued on 5 mg/kg every 8 weeks and non-responders decreased the dose interval to 6 weeks. BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI), ESR, CRP and ankylosing spondylitis assessment (ASAS) criteria were used to assess response.

Results. At 62 weeks, 11 of 15 patients (73.3%, 95% confidence interval=44.9–92.2%) from group A and three of 10 patients (30%, 95% confidence interval=6.7–65.2) from group B were responders (P=0.049). Eighty per cent (eight of 10 patients from group A) and 22.2% (two of 9 patients from group B) achieved 50% BASDAI improvement (P=0.023), and nine of 11 patients (81.8%) and four of 10 (40%) from groups A and B, respectively, reached ASAS20 at 62 weeks (P=0.08).

Conclusion. Patients on infliximab 5 mg/kg every 8 weeks with persistent disease activity may benefit from reducing the dose interval to 6 weeks.

KEY WORDS: Ankylosing spondylitis, Spondyloarthropathies, Infliximab, Anti-tumour necrosis factor-{alpha}


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