Clinical experience with infliximab for Crohn’s disease: DISCUSSION Part 1

9 May

DISCUSSIONOur initial clinical experience with infliximab for the treatment of Crohn’s disease correlates well with the initial placebo controlled studies, as well as with three retrospective studies from the United States describing response and adverse events in clinical practice settings. Very cheap drugs at your disposal – buy mircette to get best deals at best pharmacy.

The demographics of our group of patients were similar to those of patients in previously published retrospective clinical studies. All patients had severe Crohn’s disease with inadequate response to conventional therapy. The median duration of disease was 11.8 years. With respect to the use of immune modifiers, 75 of 109 patients given infliximab were receiving concomitant azathioprine, 6-mercaptopurine or methotrexate. A significant number of patients treated with infliximab were, therefore, not following the recently published guidelines for the use of infliximab in Crohn’s disease. These guidelines state that, provided that no contraindication exists, patients with Crohn’s disease who require therapy with infliximab should be considered for concomitant treatment with immunosuppressive therapy. The reason for this discrepancy is not clear; however, it may be that infliximab was administered before the dissemination of the guidelines or that infliximab was started as part of a clinical trial in which concomitant immunomodulatory therapy was not permitted. Nevertheless, it is interesting to note that the rate of global clinical response in patients who received immune modifiers (70%) was not different from that seen in all patients (73%). The finding that concomitant administration of immune modifiers in patients with Crohn’s disease did not alter the response rates to infliximab infusions is similar to previously demonstrated results but contrasts with those seen when infliximab has been used in the treatment of rheumatoid arthritis.