Determining the optimal dose of infliximab for treatment of hidradenitis suppurativa.

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.