Post-operative Crohn’s Disease Recurrence May be Prevented by Infliximab

February 9, 2009
Julia Ernst, MS

A new study has found that giving infliximab to patients after intestinal resective surgery is an effective way to prevent endoscopic and histological recurrence of Crohn’s disease.

A new study has found that giving infliximab to patients after intestinal resective surgery is an effective way to prevent endoscopic and histological recurrence of Crohn’s disease.

The patients who underwent ileocolonic resection were given intravenous infliximab (5mg/kg), beginning within four weeks of surgery, for one year, or a placebo. The primary endpoint for the study was endoscopic recurrence at the one-year point. Secondary endpoints included clinical recurrence, remission, and histological recurrence.

By the one-year point, patients receiving infliximab had a significantly lower rate of endoscopic recurrence—about 9%—compared to the placebo group, which had reached a rate of almost 85% in regard to endoscopic recurrence.

In terms of clinical remission, patients receiving infliximab reached a remission rate of 80%, while those on the placebo had a rate of about 54%. Histological recurrence at one year was significantly lower among the patients on infliximab, at about 27%, while the other group saw a histological recurrence rate of almost 85%.

This study was the first to evaluate infliximab for the prevention of postoperative Crohn’s disease. Though immunomodulator therapy has been developed, nearly three quarters of Crohn’s disease patients require an intestinal resection due to complications.

“Our study provides strong evidence that infliximab is effective at preventing endoscopic, clinical, and histological postoperative recurrence of Crohn’s disease, and provides a rationale for aggressive postoperative chemoprevention with biological therapy,” said Miguel Regueiro, MD, from the University of Pittsburgh Medical Center. “We are encouraged by our findings, which warrant future study of the duration of post-operative infliximab maintenance and appropriate endoscopic follow-up.”

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specialty: primary care