Alimentary TractTumor necrosis factor α antibody (infliximab) therapy profoundly down-regulates the inflammation in Crohn's ileocolitis☆,☆☆
Section snippets
Materials and methods
All specimens for this study were obtained from patients treated at our center as part of two randomized, double-blind, controlled trials in patients with treatment-resistant, moderate-to-severe CD. Thirteen patients were treated with infliximab (2 with 5 mg/kg, 7 with 10 mg/kg, and 4 with 20 mg/kg), and 5 were treated with placebo in addition to concomitant medications for CD (corticosteroids in 8 patients, aminosalicylates or sulfasalazine in 11 patients, azathioprine in 6 patients, and
Results
Thirteen patients were treated with infliximab (2 with 5 mg/kg, 7 with 10 mg/kg, 4 with 20 mg/kg), and 5 were treated with placebo. Patient characteristics are shown in Table 1.
Empty Cell Infliximab (n = 13) Placebo (n = 5) Age (yr)a 32.07 (20–47) 32.6 (25–41) Sex (M/F) 4/9 2/3 Disease location Colonic 6 1 Ileocolonic 6 4 Ileitis 2 0 Baseline CDAIa 329 (219–395) 290 (230–355) Concomitant medications for CD Sulfasalazine/mesalamine 7 4 Corticosteroids 5 3 Azathioprine 4 2 Antibiotics 1 2 aValues are expressed as means with
Discussion
Therapeutic options for active CD are limited. The advent of anti–TNF-α antibodies created great expectations from their early development. The mechanisms of action of infliximab are still poorly understood. Our study shows that infliximab therapy strongly interferes with the inflammatory process. Reductions of the inflammatory infiltrate are impressive and include complete disappearance of neutrophils as well as an important reduction of mononuclear cells toward normal or even subnormal
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Supported by a grant from Centocor, Inc., Malvern, Pennslyvania.
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Address requests for reprints to: Paul J. Rutgeerts, Ph.D., Department of Internal Medicine, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. e-mail: [email protected]; fax: (32) 16-34-44-19.