Infliximab prevents Crohn’s disease recurrence after ileal resection

Abstract

Evaluation of: Regueiro M, Schraut W, Baidoo L. Infliximab prevents Crohn’s disease recurrence after ileal resection. Gastroenterology 136, 441–450 (2009).

In the evaluation of drugs for the prevention of postoperative recurrence in Crohn’s disease (CD), severe endoscopic recurrence (Rutgeerts score: i-2) is the primary outcome because of its high predictive value of clinical relapse. At 1 year, severe endoscopic recurrence rates range from 30 to 79% in untreated patients. Many drugs have been evaluated in controlled clinical trials for the prevention of postoperative recurrence of CD, such as mesalamine, azathioprine/6-mercaptopurine, metronidazole/ornidazole, probiotics, budesonide and IL-10. The results of these studies are conflicting. Amongst these drugs, mesalamine and metronidazole, alone or in combination with azathioprine, have been shown to be effective in the risk reduction of postoperative recurrence of CD, with nonhomogeneous results. A recent small trial reports the role of infliximab in the prevention of severe endoscopic recurrence; the drug was effective in obtaining an absolute risk reduction of 75.5%. Considering the cost and safety problems of biological therapy, this result should be confirmed in a large trial before infliximab can be recommended for the prevention of endoscopic recurrence in CD.

Keywords::

• Crohn’s disease
• endoscopic recurrence
• ileal resection
• infliximab

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.