Posts Tagged ‘Crohn’s Disease

In a trial using infliximab for the treatment of fistulas, side effects occurring more frequently with the active treatment than with the placebo were abscesses (11%), upper respiratory tract infections (10%) and fatigue (10%). One of the 63 (1.6%) patients treated with infliximab discontinued therapy because of pneumonia. Concerns about infliximab relate to the development […]

In a trial using thalidomide 200 to 300 mg/day, sedation was reported to some extent by all patients, often requiring a reduction in the dose. Overall, three of the 22 patients (14%) discontinued the drug because of adverse events. The safety profile improved in a trial using a lower dose (50 to 100 mg/day); the […]

In general, all drugs can be used safely by physicians who have experience with specific therapeutic modalities. Nevertheless, adverse events are common with all drugs and may lead to withdrawal of therapy. Metronidazole, when used for several months at high doses, has been associated with side effects in almost all patients; these side effects often […]

INFLIXIMAB Infliximab, a humanized chimeric monoclonal antibody to tumour necrosis factor-alpha, was recently assessed in a randomized, double-blind, placebo controlled study involving 94 patients with fistulas. After a median response time of two weeks, fistulas closed in 46% (29 of 63) and 13% (four of 31) of infliximab-treated and placebo-treated patients, respectively; improvement was also […]

CYCLOSPORINE Oral administration of cyclosporine has not been shown to be effective in the healing and maintenance of closure of fistulas. Better results have been obtained with an initial high dose of cyclosporine given intravenously (4 mg/kg) followed by an oral dose of 6 to 8 mg/kg. In three uncontrolled studies, closure or improvement of […]

In a meta-analysis of five placebo controlled studies conducted between 1971 and 1980, closure or improvement of fistulas was observed in 54% of treated patients (22 of 41) and in 21% of patients taking placebo (six of 29) (odds ratio 4.44 [95% CI 1.50 to 13.20]). A duration of treatment of more than 17 weeks […]

Fistulization is a common complication of Crohn’s dis- internal or external. While fistulas between adjacent bowel ease. The clinical significance of a fistula results from its loops are frequent and often not symptomatic, internal fis-localization and symptomatic consequences. Fistulas can be tulas between distant sites (gastrocolic, rectovaginal, rectovesical) may cause severe complications. External fistulas are […]