Stability of infliximab dosing in inflammatory bowel disease: results from a multicenter US chart review

Abstract

Objective:

Infliximab dosing for inflammatory bowel disease (IBD) is based on patient weight and treatment response. Understanding dosing patterns may provide insight into treatment response and predictability of treatment cost. The purpose of this medical record review was to assess dose and dose frequency of infliximab maintenance treatment in patients with IBD using patient chart data.

Methods:

A retrospective chart review was conducted at 14 community gastroenterology clinics (GI clinics). Patients were aged ≥18 years, diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC), and had a first infliximab administration (index date) between January 1, 2005 and September 30, 2007. At least 24 months of continuous data availability were required with dosing data collected for 12 months after initiation of infliximab therapy. Patients with biologic use and/or participation in an IBD clinical trial within 12 months before the index date were excluded.

Results:

Charts from 182 CD patients and 86 UC patients were analyzed. About half of the patients were female. Over 90% of patients initiated treatment with infliximab 5 mg/kg. Among CD patients and UC patients, respectively, 79% and 61% continued receiving this dose for maintenance therapy at stable intervals.

Limitations:

This retrospective descriptive study is limited by the type and quantity of information available in patient charts from 14 GI clinics during the first year of infliximab treatment. Further, non-anti-tumor necrosis factor medication data were intermittently collected in some charts and, therefore, did not allow for analysis.

Conclusions:

Weight-based dosing and, presumably, patient response enabled providers to find the effective infliximab dose for IBD patients. The maintenance dose and administration frequency remained stable during the initial year.

Key words::

• Anti-tumor necrosis factor therapy
• Crohn’s disease
• Inflammatory bowel disease
• Infliximab
• Ulcerative colitis

Transparency

Declaration of funding

This study was funded by Centocor Ortho Biotech Services, LLC.

Declaration of financial/other relationships

J.V. and S.M. are employed by Centocor Ortho Biotech Services, LLC. H.W. was an employee of Centocor Ortho Biotech Services, LLC, at the time at which this research was conducted and is currently employed by Ethicon, Inc. O.L. and B.L. are employed by Xcenda, LLC, which has a consultant relationship with Centocor Ortho Biotech Services, LLC. M.F. was employed by Xcenda, LLC, at the time at which this research was conducted. J.G. and D.H.A. served as scientific advisors to the project and were compensated for their review of the study design and manuscript.