TY - JOUR
T1 - Infliximab in the treatment of Crohn's disease
T2 - Predictors of response in an Italian multicentric open study
AU - Orlando, A.
AU - Colombo, E.
AU - Kohn, A.
AU - Biancone, L.
AU - Rizzello, F.
AU - Viscido, A.
AU - Sostegni, R.
AU - Benazzato, L.
AU - Castiglione, F.
AU - Papi, C.
AU - Meucci, G.
AU - Riegler, G.
AU - Mocciaro, F.
AU - Cassinotti, A.
AU - Cosintino, R.
AU - Geremia, A.
AU - Morselli, C.
AU - Angelucci, E.
AU - Lavagna, A.
AU - Rispo, A.
AU - Bossa, F.
AU - Scimeca, D.
AU - Cottone, M.
PY - 2005/8
Y1 - 2005/8
N2 - Background.: Almost 20% of patients with active Crohn's disease are refractory to conventional therapy. Infliximab is a treatment of proven efficacy in this group of patients and it is not clear which variables predict a good response. Aims.: To evaluate the role of infliximab looking at the predictors of response in a large series of patients with Crohn's disease. Patients and methods.: Five hundred and seventy-three patients with luminal refractory Crohn's disease (Crohn's Disease Activity Index (CDAI) > 220-400) (312 patients) or with fistulising disease (190 patients) or both of them (71 patients) were treated with a dose of 5 mg/kg in 12 Italian referral centres. The primary endpoints of the study were clinical response and clinical remission for luminal refractory and fistulising disease. We evaluated at univariable and multivariable analysis the following variables: number of infusions, sex, age at diagnosis, smoking habit, site of disease, previous surgery, extraintestinal manifestations and concomitant therapies, and type of fistulas. Results.: Patients with luminal refractory disease: 322 patients (84.1%) had a clinical response and 228 (59.5%) reached clinical remission. Patients with fistulising disease: 187 patients (72%) had a reduction of 50% of the number of fistulas and in 107 (41%) a total closure of fistulas was observed. For luminal disease, single infusion (OR 0.49, 95% CI 0.28-0.86) and previous surgery (OR 0.53, 95% CI 0.30-0.93) predicted a worse response for fistulising disease. Other fistulas responded worse than perianal fistulas (OR 0.57, 95% CI 0.303-1.097). Conclusion.: In Crohn's disease infliximab is effective in luminal refractory and in fistulising disease. A single infusion and previous surgery predicted a worse response in luminal disease whereas perianal fistulas predicted a better response than other type of fistulas.
AB - Background.: Almost 20% of patients with active Crohn's disease are refractory to conventional therapy. Infliximab is a treatment of proven efficacy in this group of patients and it is not clear which variables predict a good response. Aims.: To evaluate the role of infliximab looking at the predictors of response in a large series of patients with Crohn's disease. Patients and methods.: Five hundred and seventy-three patients with luminal refractory Crohn's disease (Crohn's Disease Activity Index (CDAI) > 220-400) (312 patients) or with fistulising disease (190 patients) or both of them (71 patients) were treated with a dose of 5 mg/kg in 12 Italian referral centres. The primary endpoints of the study were clinical response and clinical remission for luminal refractory and fistulising disease. We evaluated at univariable and multivariable analysis the following variables: number of infusions, sex, age at diagnosis, smoking habit, site of disease, previous surgery, extraintestinal manifestations and concomitant therapies, and type of fistulas. Results.: Patients with luminal refractory disease: 322 patients (84.1%) had a clinical response and 228 (59.5%) reached clinical remission. Patients with fistulising disease: 187 patients (72%) had a reduction of 50% of the number of fistulas and in 107 (41%) a total closure of fistulas was observed. For luminal disease, single infusion (OR 0.49, 95% CI 0.28-0.86) and previous surgery (OR 0.53, 95% CI 0.30-0.93) predicted a worse response for fistulising disease. Other fistulas responded worse than perianal fistulas (OR 0.57, 95% CI 0.303-1.097). Conclusion.: In Crohn's disease infliximab is effective in luminal refractory and in fistulising disease. A single infusion and previous surgery predicted a worse response in luminal disease whereas perianal fistulas predicted a better response than other type of fistulas.
KW - Crohn's disease
KW - Infliximab
KW - Predictors of response
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U2 - 10.1016/j.dld.2005.01.019
DO - 10.1016/j.dld.2005.01.019
M3 - Article
C2 - 15886081
AN - SCOPUS:26444478543
VL - 37
SP - 577
EP - 583
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 8
ER -