Determining the optimal dose of infliximab for treatment of hidradenitis suppurativa

Abstract

Background: Few data exist to guide infliximab dosing in hidradenitis suppurativa (HS).

Objectives: To determine optimal infliximab dosing for patients with HS based on treatment response and achievement of stable dosing.

Methods: Retrospective cohort study of 52 patients with HS treated with infliximab. Primary outcome was achievement of stable dosing regimen for at least 8 weeks. Secondary outcomes were time to discontinuation, time to titration, changes to inflammatory markers, and clinical response.

Results: Thirty-five patients (67%) achieved stable dosing, most at a schedule of 10 mg/kg every 6 or 8 weeks. At 1 year from initiation, most patients (64%) required dose escalation. Patients tolerated infliximab well and achieved significant improvements in abscess and nodule count, draining sinuses, and erythrocyte sedimentation rate.

Limitations: Retrospective nature and lack of HS clinical response data for many patients.

Conclusions: Infliximab 10 mg/kg every 6 or 8 weeks may be a reasonable starting dosage for most patients.

Keywords: clinical research; drug response; general dermatology; hidradenitis; infliximab; medical dermatology.