A Prospective Open-label Trial of Remicade® in Patients With Severe Exacerbation of Crohn's Disease Requiring Hospitalization

Bhatia, Jyoti; Korelitz, Burton I.; Panagopoulos, Georgia; Lobel, Efrat Z.; Mirsky, Felice; Sultan, Keith; DiSanti, William; Chun, Alexander; Keenan, Gregory F.; Mamun, Khalid

doi:10.1097/mcg.0b013e31802c2a23

Cited by 7 publications

(4 citation statements)

References 17 publications

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“…In this regard, our case series provides complementary data to the earlier work of Bhatia et al, which demonstrated the effectiveness of first-line treatment with IFX for patients with hospitalized CD but without prior failure of inpatient CS. 11 Bhatia's study, relying on the use of historical controls of inpatient CS response from Chun et al, demonstrated that initial hospital treatment with IFX was comparable to initial treatment with CS. 13 It is worth noting that Chun's study reported an almost 90% response to inpatient CS rescue with either IV adrenocorticotropic hormone or hydrocortisone.…”

Section: Discussionmentioning

confidence: 99%

“…The study showed that IFX therapy was an effective therapy as a first-line agent, but did not include patients already failing standard first-line treatment with intravenous CS. 11…”

Section: Introductionmentioning

confidence: 99%

“…The study showed that IFX therapy was an effective therapy as a first-line agent, but did not include patients already failing standard first-line treatment with intravenous CS. 11 Although many CD hospital admissions present with complications that have progressed beyond anti-inflammatory treatment alone (such as bowel perforations, abscesses, and fibrotic strictures with bowel obstruction), many admissions are for uncontrolled inflammatory disease and its complications such as abdominal pain and diarrhea. Our goal was to perform a retrospective cohort study of hospitalized patients with CS refractory CD to investigate the efficacy of IFX as an effective rescue therapy.…”

Section: Introductionmentioning

confidence: 99%

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Infliximab as Rescue Therapy for Hospitalized Patients With Crohn's Disease Failing Intravenous Corticosteroids

Patel

Moore

Sultan

2022

American Journal of Therapeutics

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Background: Infliximab (IFX) has been shown to be effective rescue therapy for hospitalized ulcerative colitis patients failing intravenous (IV) corticosteroids (CS). There is little evidence, however, describing its use in similar hospitalized Crohn's Disease (CD) patients.Study Question: To determine if IFX is an effective rescue therapy for IV CS resistant CD patients.Study Design: A retrospective study of inpatients with CD who received IFX as rescue therapy at 2 tertiary care hospitals from January 1, 2006, to December 31, 2016. Records were reviewed for demographics, disease activity, preadmission and inpatient treatment, surgical rates, and 30-and 90-day readmission rates. Measures and Outcomes: Efficacy of IFX as rescue therapy was defined by discharge without surgery and readmission rates. Only patients failing IV CS before IFX were included in the final analysis.Results: Forty patients received IFX, of which 17 had failed IV CS. Four patients were receiving outpatient IFX therapy, but still received IV CS during hospitalization before IFX. The mean duration of IV CS therapy before IFX was 6.9 days. Of the 15 patients (88%) who responded to rescue IFX, the median hospital stay following IFX was 3 days (range 3-18 days). Readmission rates were 29% and 47% at 30 and 90 days respectively, without further surgeries noted. Conclusions:In our series of hospitalized CD patients failing IV CS, those treated with IFX had low rates of urgent surgery and a generally rapid response to treatment, supporting IFX as an effective rescue therapy. By only including those with prior failure of IV CS, we have likely excluded patients for whom IFX was given in the hospital for reasons other than severe disease. Our results suggest that individuals with severe acute CD flare can be treated with early introduction of IFX, avoiding prolonged CS use, and hospitalization.

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Section: Discussionmentioning

confidence: 99%

“…The study showed that IFX therapy was an effective therapy as a first-line agent, but did not include patients already failing standard first-line treatment with intravenous CS. 11…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Infliximab as Rescue Therapy for Hospitalized Patients With Crohn's Disease Failing Intravenous Corticosteroids

Patel

Moore

Sultan

2022

American Journal of Therapeutics

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“…For patients with severe Crohn's symptoms requiring hospitalization, intravenous steroids are commonly prescribed, and a therapeutic effect is expected within 10 days (30). In an openlabel study (31), infliximab use was associated with a reduction in mean hospital stay by three days compared with patients treated with intravenous hydrocortisone. The use of TNF antagonist drugs in hospitalized patients should only be considered after sepsis has been excluded.…”

Section: Discussion Of Statementmentioning

confidence: 99%

Canadian Association of Gastroenterology Clinical Practice Guidelines: The Use of Tumour Necrosis Factor-Alpha Antagonist Therapy in Crohn’s Disease

Sadowski

Bernstein²,

Bitton³

et al. 2009

Canadian Journal of Gastroenterology

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In the past five years, tumour necrosis factor-alpha antagonist therapy has become a cornerstone in the management of moderate-to-severe Crohn's disease refractory to conventional treatment algorithms. The evidentiary base supporting the use of these drugs in Crohn's disease is substantial and strengthened by results from longterm clinical and molecular studies. However, significant gaps in knowledge exist, particularly with regard to treatment failure. Confidence in the safety of these drugs is increasing, provided that therapy is administered in a clinical setting in which potential complications can be readily recognized and treated.

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Efficacy of Concomitant Elemental Diet Therapy in Scheduled Infliximab Therapy in Patients with Crohn’s Disease to Prevent Loss of Response

Kamata

Oshitani²,

Watanabe

et al. 2014

Dig Dis Sci

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A Prospective Open-label Trial of Remicade® in Patients With Severe Exacerbation of Crohn's Disease Requiring Hospitalization

Cited by 7 publications

References 17 publications

Infliximab as Rescue Therapy for Hospitalized Patients With Crohn's Disease Failing Intravenous Corticosteroids

Infliximab as Rescue Therapy for Hospitalized Patients With Crohn's Disease Failing Intravenous Corticosteroids

Canadian Association of Gastroenterology Clinical Practice Guidelines: The Use of Tumour Necrosis Factor-Alpha Antagonist Therapy in Crohn’s Disease

Efficacy of Concomitant Elemental Diet Therapy in Scheduled Infliximab Therapy in Patients with Crohn’s Disease to Prevent Loss of Response

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