High-dose, high-frequency infliximab: A novel treatment paradigm for hidradenitis suppurativa

Mondana H. Ghias, Andrew D. Johnston, Allison J. Kutner, Robert G. Micheletti, H. Dean Hosgood, Steven R. Cohen

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Background: The permanent disfigurement associated with hidradenitis suppurativa (HS) necessitates early aggressive disease intervention. Although limited data support the use of infliximab (IFX) in HS, the efficacy of high-dose, high-frequency IFX has yet to be defined. Objective: To evaluate the efficacy of IFX 7.5 to 10 mg/kg, with a maintenance frequency every 4 weeks. Methods: Prospective analysis of 42 patients initiating IFX 7.5 mg/kg every 4 weeks (IFX 7.5) and 16 patients receiving dose escalation to IFX 10 mg/kg every 4 weeks (IFX 10) between March 1, 2018, and February 28, 2019. The primary outcome measure (clinical response) was the proportion of patients with Physician Global Assessment of clear, minimal, or mild (score of 0-2) HS with at least a 2-grade improvement from baseline scores. Results: The proportion of patients achieving a clinical response after initiating IFX 7.5 was 20 of 42 (47.6%) at week 4 and 17 of 24 (70.8%) at week 12. For patients receiving dose escalation to IFX 10 because of incomplete initial response, 6 of 16 (37.5%) achieved clinical response at week 4 and 6 of 12 (50%) at week 12. Conclusions: Initiation of IFX 7.5 every 4 weeks, with possible dose escalation to IFX 10, if needed, provides optimal mitigation of HS-related disease activity.

Original languageEnglish (US)
Pages (from-to)1094-1101
Number of pages8
JournalJournal of the American Academy of Dermatology
Issue number5
StatePublished - May 2020


  • TNF inhibitor
  • acne inversa
  • anti-TNF
  • anti–TNF-α therapy
  • biologics
  • hidradenitis
  • hidradenitis suppurativa
  • high dose
  • high frequency
  • infliximab

ASJC Scopus subject areas

  • Dermatology


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