Therapeutic strategy for crohn's disease with a loss of response to infliximab: A single-center retrospective study

Yutaka Nagata, Motohiro Esaki, Junji Umeno, Yuta Fuyuno, Koji Ikegami, Yuji Maehata, Kouichi Asano, Tomohiko Moriyama, Shotaro Nakamura, Takanari Kitazono, Takayuki Matsumoto

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background/Aims: Infliximab (IFX) is an effective treatment for maintaining clinical remission in patients with initially moderate-to-severe Crohn's disease (CD). However, a certain number of patients become unresponsive to IFX, subsequently requiring intensified therapy. The aim of this study was to compare the short- and long-term therapeutic efficacy of intensified regimens in CD patients who fail to respond to IFX. Methods: The clinical courses of 33 CD patients who failed to respond to treatment with IFX were investigated retrospectively. An intensified regimen involving doubling the dose of IFX was chosen in 13 patients (DD group) versus shortening the IFX interval in 13 patients (SI group) and switching to adalimumab (ADA) in 7 patients (SA group). Results: The clinical response and rate of clinical remission at 4 weeks were 62 and 54% in the DD group, 77 and 62% in the SI group and 57 and 43% in the SA group, respectively (p = 0.59 for clinical response, p = 0.90 for clinical remission). The rate of sustained remission at 48 weeks was 44% in the DD group, 54% in the SI group and 33% in the SA group (p = 0.88). Conclusion: The short- and long-term efficacy of doubling the dose of IFX, shortening the interval of IFX or switching to ADA is similar for CD patients who no longer respond to IFX.

Original languageEnglish
Pages (from-to)50-56
Number of pages7
JournalDigestion
Volume91
Issue number1
DOIs
Publication statusPublished - Feb 6 2015

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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