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- Title
eHealth: individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn's disease.
- Authors
Pedersen, N.; Elkjaer, M.; Duricova, D.; Burisch, J.; Dobrzanski, C.; Andersen, N. N.; Jess, T.; Bendtsen, F.; Langholz, E.; Leotta, S.; Knudsen, T.; Thorsgaard, N.; Munkholm, P.
- Abstract
BACKGROUND: Infliximab (IFX) maintenance therapy for Crohn's disease (CD) is administered every 8 weeks, but inter-patient variation in optimal treatment intervals may exist. AIM: To assess, in a prospective pilot study, the efficacy, safety and quality of life (QoL) of IFX maintenance treatment scheduled through web-based self-monitoring of disease activity. METHODS: Twenty-seven CD patients in IFX maintenance therapy were enrolled and received a standardised disease education and web-training. Using the http://www.cd.constant-care.dk concept, patients recorded their disease activity and faecal calprotectin weekly. From this, the inflammatory burden (IB) score was calculated, placing patients in the green, yellow or red zones of a 'traffic light' system. If placed in the yellow or red zones, the computer directed these patients to consult their physician for IFX infusion. RESULTS: Seventeen patients (63%) completed 52 weeks of follow-up, 6 (22%) completed 26 weeks and 4 (15%) were excluded due to loss of response, patient decision or non-adherence. In total, 121 IFX infusions were given with a median interval of 9 (range: 4-18) weeks. Only 10% of infusions were given at 8-week intervals, whereas 39% were administered with shorter and 50% with longer intervals respectively. The mean IB and the QoL remained stable during the web-treatment. One mild infusion reaction and one case of folliculitis were observed, while three patients underwent surgery. CONCLUSIONS: The program http://www.cd.constant-care.dk appears to be a practical and safe concept for the individualised scheduling of maintenance treatment with IFX in patients with Crohn's disease. Larger studies are awaited to confirm this preliminary outcome.
- Subjects
INFLAMMATORY bowel disease treatment; INFLIXIMAB; DRUG administration; DRUG efficacy; ELECTRONIC health records; HEALTH programs
- Publication
Alimentary Pharmacology & Therapeutics, 2012, Vol 36, Issue 9, p840
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/apt.12043