Infliximab may prevent Crohn's disease recurrence

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The administration of infliximab after intestinal resective surgery was found to be effective at preventing endoscopic and histological recurrence of Crohn's disease, as per a newly released study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. To date, there have been no randomized controlled trials evaluating infliximab for postoperative Crohn's disease prevention.

"Our study provides good evidence that infliximab is effective at preventing endoscopic, clinical and histological postoperative recurrence of Crohn's disease, and provides a rationale for aggressive postoperative chemoprevention with biologic treatment," said Miguel Regueiro, MD, of the University of Pittsburgh Medical Center. "We are encouraged by our findings, which warrant future study of the duration of post-operative infliximab maintenance and appropriate endoscopic follow up".

Crohn's disease is an inflammation and ulceration process that occurs in the deep layers of the intestinal wall and usually recurs after intestinal resection. Despite the advent of immunomodulator treatment, approximately 75 percent of Crohn's disease patients require an intestinal resection for complications.

Scientists randomly assigned 24 Crohn's disease patients who had undergone ileocolonic resection to receive intravenous infliximab (5 mg/kg), administered within four weeks of surgery and continued for one year, or placebo. The study's research team elected to use endoscopic recurrence at one year as the primary study endpoint. Secondary endpoints were clinical recurrence and remission and histological recurrence.

At one year, the rate of endoscopic recurrence was significantly lower in the infliximab group (9.1 percent) in comparison to the placebo group (84.6 percent). There was a non-significant higher proportion of patients in clinical remission in the infliximab group (80 percent) in comparison to the placebo group (53.8 percent). The histological recurrence rate at one year was significantly lower in the infliximab group (27.3 percent) in comparison to the placebo group (84.6 percent).


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