Clinical experience with infliximab therapy in 100 patients with Crohn's disease

Details

Serval ID
serval:BIB_2C401A6EA6E7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical experience with infliximab therapy in 100 patients with Crohn's disease
Journal
American Journal of Gastroenterology
Author(s)
Farrell  R. J., Shah  S. A., Lodhavia  P. J., Alsahli  M., Falchuk  K. R., Michetti  P., Peppercorn  M. A.
ISSN
0002-9270 (Print)
Publication state
Published
Issued date
12/2000
Volume
95
Number
12
Pages
3490-7
Notes
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: Dec
Abstract
OBJECTIVE: The aim of this study was to assess our clinical experience with infliximab, a monoclonal antitumor necrosis factor antibody, following its approval for treatment of refractory Crohn's disease (CD). METHODS: We followed 100 consecutive patients with CD (53 women and 47 men; mean age, 41 yr) who received a total of 233 infliximab (5 mg/kg) infusions. Adverse events were noted and clinical response assessed every 2 wk for 6 months after each infusion using the Harvey Bradshaw Index (HBI) for active disease, the Perianal Disease Activity Index (PDAI) for fistulous disease, and steroid withdrawal rates for steroid-sparing efficacy. RESULTS: Indications for therapy were active disease (n = 57), perianal fistulous disease (n = 33), and steroid dependency (n = 10). Significant infusion reactions occurred in 16 patients (6.9% of infusions) including anaphylactic shock in one patient. Fourteen patients experienced infectious adverse events, 13 of whom were on concurrent steroids. Sixty percent of patients with active disease experienced > or = 50% HBI reduction at 2 wk; mean duration of response, 8.2 wk. Three of 26 first-time nonresponders with active disease (12%) responded to a second infusion. Sixty-nine percent of patients with fistulous disease experienced >50% reduction in their PDAI at 2 wk; mean duration of response, 10.9 wk. Four of 10 steroid-dependent patients (40%) discontinued steroid therapy, one of whom recommenced steroid therapy at 24 wk. CONCLUSIONS: Our clinical response rates mirror the efficacy reported in the controlled trials for active and fistulous disease. Steroid-sparing efficacy was seen in 40% of steroid-dependent patients. Concurrent steroids did not reduce the risk of significant infusion reactions (6.9%), but did increase the risk of infections.
Keywords
6-Mercaptopurine/therapeutic use Adult Anti-Inflammatory Agents/therapeutic use Antibodies, Monoclonal/administration & dosage/adverse effects/*therapeutic use Azathioprine/therapeutic use Crohn Disease/drug therapy/*therapy Female Gastrointestinal Agents/administration & dosage/adverse effects/*therapeutic use Humans Male Prednisone/therapeutic use Severity of Illness Index Time Factors
Pubmed
Web of science
Create date
25/01/2008 16:02
Last modification date
20/08/2019 13:11
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