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Remicade 10 mg reasonable starting dose for hidradenitis suppurativa

For most patients with hidradenitis suppurativa, a dosage of at least 10 mg/kg of Remicade every 8 weeks will optimize treatment, according to findings published in Journal of the American Academy of Dermatology.

“There is frequent need to escalate infliximab dosing to reach optimal disease control,” Christopher J. Sayed, MD, from the department of dermatology at the University of North Carolina, and colleagues wrote. “The primary aim of this study was to retrospectively evaluate the typical infliximab dosing regimen that results in optimal disease control by using dose titration based on patient symptoms.”

The study included a review of 52 patients with hidradenitis suppurativa treated with Remicade (infliximab, Janssen). Patients were given doses ranging from 5 mg/kg to 10 mg/kg based on provider preference at weeks 0, 2 and 6. Patients continued to receive the same dose every 8 weeks.

On average, patients received infliximab for 54.4 weeks, and the most common initial regimens were 10 mg/kg every 8 weeks (n = 36; 69%) and 7.5 mg/kg every 8 weeks (n = 10; 19%).

Results found that 67% of patients achieved stable dosing at a scheduled 10 mg/kg every 6 to 8 weeks with 64% of those patients needing an increase in dosage after 1 year. There were significant improvements in abscess and nodule count, draining sinuses and erythrocyte sedimentation rate in affected patients.

“Starting patients on an initial dosing of 10 mg/kg every 8 weeks has the potential to reduce the number of adjustments needed to achieve a stable dosing regimen with good clinical response,” the researchers wrote.

Further research is needed to characterize adverse effect profiles of higher dosages of infliximab for hidradenitis suppurativa and to determine which patients might benefit from higher or lower dosages. – by Erin T. Welsh

Disclosures: Sayed reports he is a speaker, co-investigator and advisory board member for AbbVie; a speaker and co-investigator for Novartis; an investigator and scientific advisory board member for InflaRx; and an investigator for UCB. The other authors report no relevant financial disclosures.