Inflammatory bowel disease (IBD) is the result of an unchecked intestinal inflammatory response. While the exact etiology and pathogenesis of IBD are unclear, the inflammatory response is likely initiated by luminal factors, likely bacteria or bacterial products that serve as activating antigens. By sieving through a permeable epithelial barrier, these initiating factors in turn lead to an increased exposure of the mucosal immune system to luminal antigens and toxins. In the genetically susceptible individual, this process results in an inappropriate and perpetuating mucosal immune response, with ensuing macroscopic tissue injury.
Immunosuppressors used in the treatment of IBD include azathioprine, 6-mercaptopurine, methotrexate, mycopheno-late mofetil, cyclosporine, tacrolimus and newer compounds such as infliximab that are biologically engineered. There is growing evidence that these compounds are useful for the treatment of chronically active, steroid-dependent or steroid-resistant Crohn’s disease, permitting disease remission and corticosteroid withdrawal. Cheapest medications online – cialis professional online for you to get healthy very soon.
Infliximab is a murine chimeric monoclonal antitumour necrosis factor-alpha antibody. Recent clinical trials have shown its efficacy in treating moderate to severely active and fistulizing Crohn’s disease. Reviews of the clinical experience at three major American IBD referral centres have revealed an efficacy and steroid-sparing effects that are similar to those seen in controlled clinical trials.
We examined the initial clinical experience with infliximab in the treatment of refractory inflammatory and fis-tulizing Crohn’s disease at four referral hospitals in the city of Edmonton, Alberta, with respect to its clinical efficacy and safety. The objective of the present study was to determine whether the clinical efficacy and safety of infliximab in diverse clinical practices were similar to those seen in the clinical trials.