Maintenance treatment with infliximab
Of the initial 80 patients who demonstrated a response to infliximab, 43 received one to eight additional infusions of infliximab to maintain response, with a median interval of eight weeks (range four to 56 weeks). Forty of the 43 patients continued to respond clinically to a second infusion of infliximab. Of the 29 patients who did not respond to the initial infusion, seven were given an additional infusion of infliximab. Of those, only one had a clinical response. An algorithm of the clinical outcomes with maintenance infusions is shown in Figure 2.
Figure 2) An algorithm of clinical outcome of Crohn’s disease with maintenance infusions of infliximab.
A total of 16 adverse events were recorded to be related to infliximab. Eight of 109 (7%) patients had immediate adverse events that were characterized as being related to the infliximab infusion, including headache, light-headedness, shortness of breath and rash. Only one patient had to discontinue the infliximab treatment because of an ‘ana-phylactic’-type reaction. In the other seven patients, the infusions were continued at a slower rate after administration of diphenylhydrate and/or acetaminophen. Other adverse reactions that were characterized as possibly related to the infliximab infusion included a flare of gout (one patient), diffuse transient joint pain (one patient), chest pain (one patient two days after the infusion), rash (four patients, one of which discontinued therapy) and activation of varicella zoster (one patient). Your most trusted pharmacy offering and giving you very fast shipping.
Ten of 29 patients (34%) required surgery for their Crohn’s disease. One patient required resection of a stricture but did not have active disease at the time of resection. A second patient had closure of an ileostomy after resolution of fistulae. A third patient had a reversal of a Hartman’s procedure after improvement of symptoms. The remainder of the patients – seven of 29 (24%) – underwent surgery for nonresponse to infliximab therapy.