Infliximab retreatment in luminal Crohn’s disease

After discontinuation of infliximab due to loss of response or intolerance, infliximab retreatment is safe and efficient in more than one third of Crohn’s disease (CD) patients regardless of the reason of prior discontinuation. This was concluded from a prospective, multicentre, observational cohort study, which included 96 patients with active luminal CD who resumed infliximab therapy after at least 6 months of discontinuation [1].

At baseline, patients had clinically (Crohn's Disease Activity Index [CDAI]>150) and objectively active CD. The reintroduction schedule included 3 infliximab infusions at weeks 0, 4, and 8, after a systematic premedication. Maintenance treatment was administered every 8 weeks. At week 26, 34 patients (35%) reached the primary endpoint of efficacy, defined as a CDAI <150 in the absence of infliximab discontinuation or use of corticosteroid therapy, surgery, or another biologic. No significant difference was observed in rates of clinical remission in patients with initial secondary loss of response (38%) and those with infliximab intolerance (33%) (P=0.9). A total of 37 patients (36%) had an intolerance reaction to retreatment after an average of 3 infliximab infusions, requiring drug discontinuation for 31 (30%) patients. Optimisation of infliximab treatment by increasing doses and/or frequency of infusions was necessary in 45 patients (47%) during the 12-month follow-up period. Neither the presence of anti-drug antibodies at baseline nor infliximab trough level at week 8 were predictive of infliximab retreatment failure.

1. Boschetti G, et al. ECCO 2019, P714.



Posted on 9 May 20199 April 2024