Document Detail


Successful management of Crohn's disease of the ileoanal pouch with infliximab.
MedLine Citation:
PMID:  10419926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study reports the clinical benefit and safety of the murine chimeric anti-tumor necrosis factor (TNF)-alpha monoclonal antibody, infliximab, in the treatment of patients who developed findings compatible with Crohn's disease after undergoing colectomy with ileal-pouch anal anastomosis (IPAA) for an original diagnosis of ulcerative colitis. Medical records of 7 patients with Crohn's disease and an IPAA treated with infliximab were reviewed. Clinical response was classified as complete response, partial response, and no response. Concurrent treatment with immune modifier agents and/or antibiotics was recorded. Seven patients with active inflammatory or fistulizing Crohn's disease and an IPAA performed for diagnosis of ulcerative colitis were treated with infliximab after they had no response to conventional therapies. Patients received 1-4 infliximab infusions at a dose of 5 mg/kg. All patients improved clinically. Six patients had a complete response, and 1 had a partial response. Four of the 5 patients with complex perianal and fistulizing disease had closure of all fistula tracts, and 1 patient improved temporarily. Six of the 7 patients underwent concurrent treatment with immune modifier drugs. One patient had myalgias and malaise after the first infliximab infusion and flu-like symptoms after the second one. No other adverse effects were observed. This case series demonstrates that the murine chimeric anti-TNF-alpha monoclonal antibody, infliximab, can be used successfully to treat patients with Crohn's disease involving an IPAA who are refractory to conventional therapies.
Authors:
E Ricart; R Panaccione; E V Loftus; W J Tremaine; W J Sandborn
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gastroenterology     Volume:  117     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-08-26     Completed Date:  1999-08-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  429-32     Citation Subset:  AIM; IM    
Affiliation:
Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Monoclonal / adverse effects,  therapeutic use*
Crohn Disease / therapy*
Female
Humans
Male
Middle Aged
Proctocolectomy, Restorative*
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/infliximab
Comments/Corrections
Comment In:
Gastroenterology. 2003 Aug;125(2):631-3; author reply 633   [PMID:  12891580 ]

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


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