Objectives: Infliximab has clearly demonstrated its efficacy in the short-term treatment of fistulizing Crohn's disease. We present here the results of retreatment and long-term maintenance therapy.
Patients And Methods: Eighty one consecutive patients with active fistulizing Crohn's disease, in whom previous treatments had failed, were treated with infliximab. All patients received as the initial treatment of 5 mg/kg i.v. infusions (weeks 0, 2, and 6). Those patients who failed to respond after the initial cycle (group 1, n = 25), or those who relapsed after having responded (group 2, n = 13), received retreatment with three similar doses (weeks 0,2, and 6). Those who responded to retreatment were included in a long-term maintenance programme (n = 44), with repeated doses (5 mg/kg i.v. infusions) every eight weeks for 1-2 years.
Results: In the initial treatment 56% of the patients responded partially; this response being complete in 44%. In the retreatment, 28% of group 1 (non-responders) presented a complete response, compared to 77% in group 2 (relapsers) (p < 0.0001). In the maintenance treatment, the global response was 88% (39/44). The mean number of doses per patient was 4.4 +/- 2 (range 1-9) with a duration of 36 +/- 12 weeks (range 8-72). Adverse effects were not significantly increased in either treatment.
Conclusions: Both retreatment and long-term maintenance therapy with infliximab, are highly effective and well tolerated in fistulizing Crohn's disease patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.4321/s1130-01082004000800004 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Rare Enterohepatic Fistula in Crohn's Disease: Case Analysis and Literature Synthesis.
Am J Case Rep
January 2025
Department of Surgery, Cantonal Hospital of Fribourg (HFR), Villars-sur-Glâne, Switzerland.
BACKGROUND Crohn disease is a chronic inflammatory bowel disease known for causing fistulous tracts, abscesses, and bowel perforation. Enterohepatic fistulas, a rare but significant complication, are scarcely reported. This article presents the case of a hepatic abscess due to an enterohepatic fistula in a patient with long-term Crohn disease and reviews the existing literature on this phenomenon.
View Article and Find Full Text PDFInfliximab and adalimumab in the treatment of fistulizing Crohn's disease: a propensity score-matched analysis from the prospective Persistence Australian National IBD Cohort (PANIC4) study.
Am J Gastroenterol
December 2024
Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia.
Background/aims: There are spare data on comparative medication efficacy in fistulizing Crohn's disease (FCD), particularly with immunomodulator co-therapy. Persistence is a unique way to assess real-world outcomes.
Methods: The persistence of all dispensed biological agents were analysed from the Australian Pharmaceutical Benefits Scheme (PBS) registry data 2005-2021 for FCD.
Diagnosing Crohn's Disease in Presumed Cryptoglandular Perianal Fistulas: An Expert Delphi Consensus on Early Identification of Patients at Risk of Crohn's Disease in Perianal Fistulas (PREFAB).
J Crohns Colitis
January 2025
Department of Surgery, Flevoziekenhuis, Almere, The Netherlands.
Background: The aim of this Delphi study was to reach consensus on a new clinical decision tool to help identify or exclude Crohn's disease (CD) in patients with perianal fistula(s) (PAF).
Methods: A panel of international experts in the field of proctology/Inflammatory Bowel Disease (IBD) were invited to participate. In the first round (electronic survey), participants were asked to anonymously provide their opinion probing 1) the relevance and use of clinical characteristics suggestive of underlying CD, 2) the use of faecal calprotectin (FCP) for screening for CD and 3) on the diagnostic work-up for CD in PAF patients with raised clinical suspicion.
Impact of Nursing Interventions via Telephone and Email on the Quality of Life of Patients with Inflammatory Bowel Disease: Preliminary Results of a Comparative Observational Study.
Healthcare (Basel)
December 2024
Department of Clinical and Experimental Medicine, University of Catanzaro MagnaGraecia, 88100 Catanzaro, Italy.
Background: Inflammatory bowel disease (IBD), encompassing ulcerative colitis and Crohn's disease, is a heterogeneous chronic condition characterized by periods of relapse and remission. Ulcerative colitis involves inflammation of the colon and rectum mucosa, while Crohn's disease causes deeper, transmural inflammation affecting all four gut layers from the mouth to the anus and can lead to complications such as fistulation. IBD significantly impacts patients' physical and psychological well-being, thus reducing their quality of life (QoL).
View Article and Find Full Text PDFManagement of Perianal Fistulizing Crohn's Disease According to Principles of Wound Repair.
Aliment Pharmacol Ther
February 2025
Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Background: Perianal fistulizing Crohn's disease (PFCD) is a challenging and debilitating phenotype of Crohn's disease that can negatively affect quality of life. Studies have begun to uncover the physiologic mechanisms involved in wound repair as it relates to PFCD and how aberrations in these mechanisms may contribute to fistula persistence.
Aims: To review the physiologic and pathophysiologic mechanisms of wound repair in PFCD and how specific therapeutic strategies may impact their outcomes.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!