Clinical experience with infliximab for Crohn’s disease: DISCUSSION Part 2

10 May

DISCUSSIONOne hundred three of 109 patients with Crohn’s disease in our study had failed to achieve remission with corticosteroids. Initiating infliximab treatment in this corticosteroid-refractory group of patients achieved an overall clinical response rate in all disease groups of 73% (17% complete response and 55% partial response).

The results of our Edmonton retrospective clinical practice review were similar to those reported from three IBD referral centres in the United States (Rochester, Minnesota; Chicago, Illinois; and Providence, Rhode Island). The results for clinical response in inflammatory luminal and fistulizing Crohn’s disease in the Edmonton study (67% and 82%, respectively) were similar to those previously published from Rochester, Minnesota (72% and 64%, respectively), Chicago, Illinois (65% and 78%, respectively) and Providence, Rhode Island (60% and 69%, respectively). Buy drugs with confidence – to see how cheap your treatment can be.

In contrast to the similar clinical responses to infliximab seen among these centres, the percentage of patients with inflammatory luminal and fistulizing Crohn’s disease determined to have a complete response (ie, remission) in the Edmonton study (15% and 29%, respectively) was noticeably less than the percentages identified from Rochester, Minnesota (52% and 34%, respectively), Chicago, Illinois (31% and 24%, respectively) and Providence, Rhode Island (60% and 64%, respectively). The exact reason for this discrepancy is unclear because all studies used similar methodological clinical end points to determine remission. However, it is very likely that the differences are related to patient and physician interpretation and assessment of ‘complete remission’.