[Optimizing effect of infliximab upon inflammatory bowel disease]

Area of Science:

• Gastroenterology
• Immunology
• Pharmacology

Background:

• Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), presents significant therapeutic challenges.
• Conventional treatments like corticosteroids are often insufficient for many patients, leading to resistance or dependency.

Purpose of the Study:

• To evaluate the optimal therapeutic effect of infliximab (IFX) in patients with inflammatory bowel disease.
• To assess the safety and efficacy profile of IFX in a cohort of IBD patients, including those refractory to other treatments.

Main Methods:

• A cohort of eight IBD patients (5 CD, 3 UC) received infliximab (IFX) at 5 mg/kg at weeks 0, 2, and 6, followed by maintenance therapy every 8 weeks.
• Patient characteristics included corticosteroid resistance (5 cases), corticosteroid dependency (2 cases), and one naive patient.
• Long-term follow-up was conducted to assess treatment outcomes.

Main Results:

• All eight patients demonstrated a positive response to the infliximab treatment regimen.
• Clinical responses varied, with two CD patients achieving complete remission and two showing clinical response. One CD case had an indeterminate outcome.
• In ulcerative colitis (UC) patients, one achieved complete remission, and two showed a response. No serious adverse events were reported during therapy.

Conclusions:

• Optimal infliximab (IFX) therapy involves careful patient selection, tailored protocols, and dose adjustments based on therapeutic response.
• Combining IFX with immunomodulators like budesonide may enhance efficacy.
• Assessing treatment success via endoscopic mucosal healing, rather than solely symptom-based evaluation, is crucial for preventing disease recurrence and minimizing side effects.