eHealth: individualisation of infliximab treatment and disease course via a self-managed web-based solution in Crohn’s disease

Research output: Contribution to journalJournal articlepeer-review

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 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 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.

Original languageEnglish
JournalAlimentary Pharmacology and Therapeutics
Issue number9
Pages (from-to)840-9
Number of pages10
Publication statusPublished - Nov 2012

    Research areas

  • Adolescent, Adult, Aged, Antibodies, Monoclonal/administration & dosage, Crohn Disease/drug therapy, Denmark, Female, Gastrointestinal Agents/administration & dosage, Health Knowledge, Attitudes, Practice, Humans, Infliximab, Internet, Male, Middle Aged, Patient Education as Topic, Pilot Projects, Prospective Studies, Self Administration/methods, Self Care/methods, Severity of Illness Index, Surveys and Questionnaires, Telemedicine, Treatment Outcome, Young Adult

ID: 219528330