Remicade at Higher Than Usual Doses Seen as Effective and Safe in Controlling Inflammation in IBD Patients

Remicade at Higher Than Usual Doses Seen as Effective and Safe in Controlling Inflammation in IBD Patients
Higher doses of Remicade (infliximab) can ease the symptoms of inflammatory bowel disease (IBD) by better controlling inflammation with raising the risk of adverse effects — like more infections — in patients, researchers report. Their study, “Success and safety of high infliximab trough levels in inflammatory bowel disease,” was published in the Scandinavian Journal of Gastroenterology. Remicade an antibody biological treatment that works against tumor necrosis factor alpha (TNF-α), one of the most potent inflammatory molecules in the body. Remicade is an approved infusion treatment for several autoimmune disorders, including moderately to severely active Crohn’s disease, ulcerative colitis, and rheumatoid arthritis. A previous prospective trial suggested that a Remicade dose with trough levels between three and seven µg/mL is appropriated to treat patients with IBD. (A trough level is the lowest concentration of a medicine in a patient's bloodstream, a level estimated just prior to a next administration of a treatment.) But some researchers propose higher doses might better treat the disease, including 10 µg/mL or even 18 µg/mL of Remicade. "It is important to delineate the TL [trough level] of infliximab above which no clinical benefit can be expected, since those patients should be offered other treatment options, such as vedolizumab or ustekinumab," the researchers wrote. "But it is equally important not to discontinue infliximab and switch to a different class of biologics too soon as second line non-TNF biologicals are only modestly effective in patients who failed TNF inhibitors." In this study, a research team from Ljubljana, Slovenia, hypothesized that Remicade at a dose higher than the current suggested therapeutic dose
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