Need for infliximab dose intensification in Crohn’s disease and ulcerative colitis

Table 1 Baseline characteristics of the patients enrolled n (%)

Baseline characteristics	Ulcerative colitis	Crohn’s disease	P
	(n = 38)	(n = 59)
Sex
Men	16 (42.1)	33 (55.9)	0.184
Women	22 (57.9)	26 (44.1)
Age (mean ± SD, yr)	41.9 (14.2)	38.9 (38.9)	0.312
Duration of disease [median (interquartile range), yr]	4.5 (2-10.3)	6 (1-12)	0.738
Smoking status
Non-smoker	15 (39.5)	21 (35.6)	0.003
Smoker	8 (21.1)	30 (50.8)
Ex-smoker	15 (39.5)	8 (13.6)
Steroid status
Neither steroid dependent nor refractory	0	19 (32.2)	< 0.001
Steroid dependent	21 (55.3)	33 (55.9)
Steroid refractory	17 (44.7)	7 (11.9)
Steroid use at induction
No	10 (26.3)	38 (64.4)	< 0.001
Yes	28 (73.7)	21 (35.6)
Immunomodulator therapy
No	7 (18.4)	14 (23.7)	0.536
Yes	31 (81.6)	45 (76.3)

Table 2 Summary of dose intensification

Dose intensification	Ulcerative colitis	Crohn’s disease	P value
	(n = 38)	(n = 59)
Time on infliximab1 [median (interquartile range), mo]	9 (5.2-12.5)	13.1 (8.1-23.3)	0.006
Rate of intensification per patient-month	3.9%	1.4%	0.005
Time to infliximab intensification [median (interquartile range), mo]	6.6 (4.2-9.5)	10.7 (8.9-15.7)	0.005

¹Time on infliximab: Interval of time between the first infliximab induction dose and the first infliximab intensified dose, or for patients who did not require dose intensification time between the initiation of infliximab and either the last follow-up visit or the time of infliximab discontinuation.

Table 3 Summary of factors associated with dose intensification in the multivariate analysis

Factor	Adjusted Hazard ratio	95%CI	P value
Corticosteroid dependence (yes/no)	1.359	0.425-4.343	0.605
Age	1.015	0.991-1.040	0.216
Induction with corticosteroids (yes/no)	1.258	0.521-3.041	0.610
0Immunomodulator use (yes/no)	0.510	0.242-1.073	0.076
Disease (ulcerative colitis vs Crohn´s disease)	2.732	1.313-5.686	0.007

Table 4 Summary of studies of infliximab dose intensification in ulcerative colitis: Proportion of patients who needed infliximab intensification

Ref.	Patients1	Median duration of follow-up (mo)	Dose intensification
Rostholder et al[7]	50	142	54%
Oussalah et al[8]	80	18	45%
Seow et al[9]	93	14	58%
Arias et al[10]	136	14	46%
Present study	38	9	42%

¹Only patients who responded and started maintenance therapy;

²Mean duration.