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[Infliximab therapy for Crohn's disease anoperineal lesions]
A Ouraghi1, S Nieuviarts, J L Mougenel
1Services d'Hépato-Gastroentérologie, CHU, Lille, France.
Gastroenterologie Clinique Et Biologique
|February 15, 2002
Summary
Remicade (infliximab) effectively treats severe anoperineal Crohn's disease lesions, showing rapid response and good tolerance. However, a high relapse rate necessitates long-term treatment strategies for sustained remission.
Area of Science:
- Gastroenterology
- Immunology
- Inflammatory Bowel Disease
Background:
- Anoperineal manifestations of Crohn's disease significantly impact patient quality of life.
- Refractory perianal lesions often require advanced therapeutic interventions.
Purpose of the Study:
- To evaluate the efficacy, duration of response, and safety of Remicade (infliximab) in patients with severe anoperineal Crohn's disease.
- To assess treatment outcomes for fistulae and ulcerative lesions in the perianal region.
Main Methods:
- Retrospective analysis of 50 patients with severe, refractory anoperineal Crohn's disease.
- Treatment involved three intravenous infusions of Remicade (5 mg/kg) at weeks 0, 2, and 6.
- Efficacy assessed by Allan's functional score and proctologic examination at 8 and 24 weeks.
Main Results:
- At 8 weeks, Remicade showed response rates of 71% for fistulae and 79% for ulcers/fissures, with healing rates of 39% and 49%, respectively.
- At 24 weeks, response rates were 58% for fistulae and 63% for ulcers/fissures.
- Median response duration was 9.5 months, but the 1-year relapse rate was 64%.
Conclusions:
- Remicade demonstrates rapid efficacy and good tolerability for anoperineal Crohn's disease lesions.
- The high rate of relapse highlights the need for comprehensive, long-term management plans.