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  • Title: [Treatment of Crohn's disease with anti-TNF alpha antibodies (infliximab): results of a multicentric and retrospective study].
    Author: Doubremelle M, Bourreille A, Zerbib F, Heresbach D, Metman EH, Beau P, Gournay J, Galmiche JP.
    Journal: Gastroenterol Clin Biol; 2002 Nov; 26(11):973-9. PubMed ID: 12483127.
    Abstract:
    OBJECTIVE: To evaluate the results of infliximab therapy, an anti-TNF-alpha antibody, in patients with severe and refractory Crohn's disease or with fistulas, treated outside the setting of a therapeutic trial. METHODS: All Crohn's disease patients treated at the Departments of Gastroenterology of the University Hospitals of Bordeaux, Nantes, Poitiers, Rennes and Tours were retrospectively analyzed. RESULTS: Sixty-nine patients were treated with a total of 170 infusions of infliximab, 32 patients being treated for refractory Crohn's disease and 37 for fistulas. The median follow-up was 8 months (extremes 1-20). An objective response was observed in 79% of refractory Crohn's disease patients and 78% of fistulazing patients. A remission was observed in 72% and 70% of the patients respectively. Forty-five percent of patients had relapsed within 4 months (extremes 2-7). Immunosuppressive therapy was associated with a lower relapse rate (18% with versus 56% without, P=0.004). Infliximab resulted in a steroid-sparing effect in 73% of patients. Forty adverse events, none of severe grade, were observed in 22% of the patients, without any influence of steroids or immunosuppressive therapy. CONCLUSION: This study confirms that infliximab is very effective in steroid-dependent and fistulazing Crohn's disease. Infliximab has a steroid-sparing effect and immunosuppressive therapy is associated with a reduced relapse rate. Although the tolerance is good in the short term, long term safety remains to be established by further studies.
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