Infliximab-Based Strategies Beneficial in Crohn's Disease

Remission outcome more likely with infliximab, infliximab-azathioprine than azathioprine alone

WEDNESDAY, April 14 (HealthDay News) -- Compared to azathioprine alone, the use of infliximab or infliximab plus azathioprine is associated with a greater likelihood of corticosteroid-free clinical remission in patients with moderate to severe Crohn's disease, according to research published in the April 15 issue of the New England Journal of Medicine.

Jean Frédéric Colombel, M.D., of the Université Lille Nord de France, and colleagues analyzed data from 508 adults with moderate to severe Crohn's disease who had not previously received immunosuppressive or biologic therapy. Participants were randomized to receive intravenous infliximab plus placebo, oral azathioprine plus placebo, or a combination of infliximab and azathioprine.

The researchers found that 56.8 percent of the combination group were in corticosteroid-free clinical remission at week 26, compared to 44.4 percent of the infliximab group and 30 percent of the azathioprine group. They observed similar trends at week 50. Also at week 26, mucosal healing was noted in 43.9, 30.1 and 16.5 percent of these groups, respectively. Serious infections occurred in 3.9 percent of the combination group, 4.9 percent of the infliximab group, and 5.6 percent of the azathioprine group.

"In conclusion, infliximab monotherapy and combination therapy with infliximab plus azathioprine, as compared with azathioprine alone, resulted in significantly higher rates of corticosteroid-free clinical remission among patients with moderate to severe Crohn's disease. Combination therapy was the most effective treatment," the authors conclude.

The study was supported by Centocor Ortho Biotech, which makes infliximab, and Schering-Plough. A number of study authors disclosed financial relationships with these and other companies.

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