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Repeated infusions of infliximab, a chimeric anti-TNFα monoclonal antibody, in patients with active spondyloarthropathy: one year follow up
  1. E Kruithof,
  2. F Van den Bosch,
  3. D Baeten,
  4. A Herssens,
  5. F De Keyser,
  6. H Mielants,
  7. E M Veys
  1. Department of Rheumatology, Ghent University Hospital, Belgium
  1. Correspondence to:
    Dr E Kruithof, Department of Rheumatology, OK12IB, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium;
    elli.kruithof{at}rug.ac.be

Abstract

Background: In a pilot study, the anti-tumour necrosis factor α monoclonal antibody, infliximab, induced a rapid and significant improvement in global, peripheral, and axial disease manifestations of patients with active spondyloarthropathy.

Objective: To determine whether repeated infusions of infliximab would effectively and safely maintain the observed effect.

Methods: Safety and efficacy of a maintenance regimen (5 mg/kg infliximab every 14 weeks) was evaluated using the measurements reported in the pilot study. Of the 21 patients, 19 completed the one year follow up for efficacy; two patients changed to another dosing regimen after week 12 owing to partial lack of efficacy. However, they are still being followed up for safety analysis.

Results: After each re-treatment a sustained significant decrease of all disease manifestations was observed. Before re-treatment, symptoms recurred in 3/19 (16%) at week 20, in 13/19 (68%) at week 34, and in 15/19 (79%) at week 48. No withdrawals due to adverse events occurred. Twelve minor infectious episodes were observed. Twelve patients (57%) developed antinuclear antibodies; in four of them (19%) anti-dsDNA antibodies were detected. However, no lupus-like symptoms occurred.

Conclusion: In this open study of infliximab in patients with active spondyloarthropathy, the significant improvement of all disease manifestations was maintained over a one year follow up period without major adverse events. Although recurrence of symptoms was noted in a rising number of patients before each re-treatment, no loss of efficacy was observed after re-treatment.

  • spondyloarthropathy
  • ankylosing spondylitis
  • psoriatic arthritis
  • anti-TNFα
  • ANA, antinuclear antibodies
  • AS, ankylosing spondylitis
  • CRP, C reactive protein
  • ESR, erythrocyte sedimentation rate
  • PsA, psoriatic arthritis
  • RA, rheumatoid arthritis
  • SpA, spondyloarthropathies
  • TNFα, tumour necrosis factor α
  • uSpA, undifferentiated spondyloarthropathy
  • VAS, visual analogue scale
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