Document Detail


Effects of infliximab therapy on transmural lesions as assessed by magnetic resonance enteroclysis in patients with ileal Crohn's disease.
MedLine Citation:
PMID:  23411006     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: Anti TNF therapy induces mucosal healing in patients with Crohn's disease, but the effects on transmural inflammation in the ileum are not well understood. Magnetic resonance-enteroclysis (MRE) offers excellent imaging of transmural and peri-enteric lesions in Crohn's ileitis and we aimed to study its responsiveness to anti TNF therapy. METHODS: In this multi-center prospective trial, anti TNF naïve patients with ileal Crohn's disease and with increased CRP and contrast enhanced wall thickening received infliximab 5mg/kg at weeks 0, 2 and 6, and q8 weeks maintenance MRE was performed at baseline, 2 weeks and 6 months and assessed based on a predefined MRE score of severity in ileal Crohn's Disease. RESULTS: Twenty patients were included; of those, 18 patients underwent MRE at week 2 and 15 patients at weeks 2 and 26 as scheduled. Inflammatory components of the MRE index decreased by ≥2 points and by ≥50% at week 26 (primary endpoint) in 40% and 32% of patients (per protocol and intention to treat analysis, respectively). The MRE index improved in 44% at week 2 and in 80% at week 26. Complete absence of inflammatory lesions was observed in 0/18 at week 2 and 13% (2/15) at week 26. The obstructive elements did not change. Clinical and CRP improvement occurred as early as wk 2, but only CDAI correlated with the MRE index. CONCLUSION: Improvement of MRE occurs from 2 weeks after infliximab therapy onwards and correlates with clinical response but normalization of MRE is rare.
Authors:
Gert Van Assche; Karin A Herrmann; Edouard Louis; Simon M Everett; Jean-Frédéric Colombel; Jean-François Rahier; Dirk Vanbeckevoort; Paul Meunier; Damian Tolan; Olivier Ernst; Paul Rutgeerts; Séverine Vermeire; Isolde Aerden; Alessandra Oortwijn; Thomas Ochsenkühn
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-11
Journal Detail:
Title:  Journal of Crohn's & colitis     Volume:  -     ISSN:  1876-4479     ISO Abbreviation:  J Crohns Colitis     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101318676     Medline TA:  J Crohns Colitis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
Affiliation:
University of Toronto, Ontario, Canada; University of Toronto, Ontario, Canada. Electronic address: gvanassche@mtsinai.on.ca.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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