factors influencing mucosal healing in Crohn's disease during infliximab treatment

Hepatogastroenterology. 2013 Jul-Aug;60(125):1041-6. doi: 10.5754/hge11514.

Abstract

Background/aims: The effect of infliximab (IFX) on mucosal healing (MH) in clinical setting, as well as what is the effect of scaring of profound ulcers on bowel, is not well known. Aim of our study was to assess how MH occurs in Crohn's disease (CD) in clinical setting during treatment with IFX.

Methodology: Forty patients with CD were followed-up. MH and endoscopic remission (ER) were assessed. Some factors were investigated in predicting development of "uncomplicated" (ulcer healing without alteration of bowel profile) or "complicated" (ulcer healing with alteration of bowel profile) MH.

Results: IFX was administered for a mean of 36 months. MH ranged from 67.5% of cases after 6 months to 42.5% of cases after 3 year of treatment. ER ranged from 87.5% of cases after 6 months to 52.5% of cases after 3 year of treatment. Mean CDEIS score decreased from 28 to 8 at the end of follow-up. Uncomplicated MH occurs in 70.37% of patients, complicated MH occurred in 29.63% of patients. Complicated MH was recorded more frequently in patients with severe CDAI (>300 vs. <300, p <0.0362) and higher CDEIS (>35 vs. <35, p >0.0342).

Conclusions: Complicated MH seems to occur frequently in clinical practice when using IFX, especially in patients with higher indexes of activity at entry.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Monoclonal / therapeutic use*
  • Crohn Disease / drug therapy*
  • Crohn Disease / physiopathology
  • Female
  • Humans
  • Infliximab
  • Intestinal Mucosa / drug effects*
  • Intestinal Mucosa / physiopathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Wound Healing / drug effects*

Substances

  • Antibodies, Monoclonal
  • Tumor Necrosis Factor-alpha
  • Infliximab