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
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
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 17:02
Last modification date
20/08/2019 14:11