Document Detail


Impact of infliximab therapy after early endoscopic recurrence following ileocolonic resection of Crohn's disease: a prospective pilot study.
MedLine Citation:
PMID:  19266566     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The efficacy of infliximab for endoscopic recurrence after resection of Crohn's disease (CD) has not yet been reported. The aim of this prospective study was to investigate the impact of infliximab on early endoscopic lesions after resection for CD. METHODS: Twenty-six patients maintaining clinical remission (CD activity index [CDAI] score <150) with mesalamine (3 g/day) after resection showed endoscopic recurrence in the neoterminal ileum at 6 months postoperatively (=baseline). Over the following 6 months, 10 patients were treated with continuous mesalamine (3 g/day), 8 patients were treated with azathioprine therapy (50 mg/day), and the other 8 patients were treated with infliximab therapy (5 mg/kg, every 8 weeks). During ileocolonoscopy at baseline and 6 months later, mucosal biopsies were taken for cytokine assays. RESULTS: During 6-month observation, no patients in the infliximab group, 3 (38%) in the azathioprine group, and 7 (70%) in the mesalamine group developed clinical recurrence (CDAI >or=150) (P = 0.01). At 6 months, endoscopic inflammation was improved in 75% of patients in the infliximab group, 38% in the azathioprine group, and 0% in the mesalamine group (P = 0.006). The mucosal interleukin (IL)-1beta, IL-6, and tumor necrosis factor-alpha levels significantly decreased in the infliximab group, while they significantly increased in the mesalamine group, and they did not change significantly in the azathioprine group. CONCLUSIONS: Infliximab therapy showed clear suppressive effects on clinical and endoscopic disease activity, and mucosal cytokine production in patients with early endoscopic lesions after resection. To confirm our conclusions, randomized controlled trials with a larger number of patients are necessary.
Authors:
Takayuki Yamamoto; Satoru Umegae; Koichi Matsumoto
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Inflammatory bowel diseases     Volume:  15     ISSN:  1536-4844     ISO Abbreviation:  Inflamm. Bowel Dis.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-21     Completed Date:  2009-12-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508162     Medline TA:  Inflamm Bowel Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1460-6     Citation Subset:  IM    
Affiliation:
Inflammatory Bowel Disease Center & Department of Surgery, Yokkaichi Social Insurance Hospital, Yokkaichi, Mie, Japan. naotaka@sannet.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anti-Inflammatory Agents / therapeutic use*
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Antibodies, Monoclonal / therapeutic use*
Azathioprine / therapeutic use
Colonoscopy
Crohn Disease / complications*,  pathology,  surgery*
Enzyme-Linked Immunosorbent Assay
Female
Follow-Up Studies
Humans
Immunosuppressive Agents / therapeutic use
Interleukin-1beta / metabolism
Interleukin-6 / metabolism
Male
Mesalamine / therapeutic use
Middle Aged
Pilot Projects
Postoperative Complications / drug therapy*
Prognosis
Prospective Studies
Recurrence / prevention & control*
Tumor Necrosis Factor-alpha / metabolism
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Antibodies, Monoclonal; 0/Immunosuppressive Agents; 0/Interleukin-1beta; 0/Interleukin-6; 0/Tumor Necrosis Factor-alpha; 0/infliximab; 446-86-6/Azathioprine; 89-57-6/Mesalamine
Comments/Corrections
Comment In:
Inflamm Bowel Dis. 2009 Oct;15(10):1458-9   [PMID:  19462431 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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