Original article—alimentary tractLow-Dose Maintenance Therapy With Infliximab Prevents Postsurgical Recurrence of Crohn's Disease
Section snippets
Patients and Methods
We enrolled in the current study a total of 12 consecutive patients treated postoperatively with infliximab and free of clinical and endoscopic recurrence at 2 years.3 The clinical features of all 12 patients are outlined in Table 1. Age ranged from 23 to 64 years (median, 38 y). Six of these patients had an ileocecal resection (during which a fistula tract was removed in 3 of the patients), 2 patients had a segmental ileal resection (the patients previously had been subjected to ileocecal
Results
A total of 12 patients treated immediately postoperatively with infliximab 5 mg/kg bw on a maintenance basis and free of clinical and endoscopic recurrence at 2 years were given infliximab for another year at the same dose and colonoscopy was performed immediately thereafter. None of the patients had mucosal or clinical recurrence as defined in the Patients and Methods section, and none of them reported serious side effects. We only recorded mild, single, short-lived, self-limiting episodes of
Discussion
Prevention of postsurgical recurrence of Crohn's disease is a fundamental task in the practical management of patients with this condition. Indeed, as of today, the large majority of affected individuals will undergo surgery within a few years of diagnosis.16 After surgery, the disease tends to occur in a similar fashion and usually within a short time. If left untreated, approximately 80% of patients will have an endoscopic recurrence within 1 year from surgery, and in a large majority of them
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This article has an accompanying continuing medical education activity on page e79. Learning Objectives—At the end of this activity, the learner should be able to understand the role of infliximab in the prevention of postsurgical Crohn's disease.
Conflicts of interest The authors disclose the following: Dario Sorrentino has acted as a consultant and received fees from Schering-Plough, Centocor, and Abbott (study participants were informed about the potential conflicts of interest). The remaining authors disclose no conflicts.
This study was not supported by the pharmaceutical industry.
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