Local injection of infliximab in the postoperative recurrence of Crohn's disease

Biancone, Livia; Cretella, M.; Tosti, C.; Palmieri, Giampiero; Petruzziello, C.; Geremia, A; Calabrese, Emma; Pallone, Francesco

doi:10.1016/j.gie.2005.08.047

Cited by 48 publications

(26 citation statements)

References 32 publications

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“…In a small open-label study in 8 patients with localized, clinically inactive recurrence of inflammatory Crohn’s disease, lesions were endoscopically injected with infliximab and controlled endoscopically 2–4 weeks later. Endoscopic scores of severity were reduced without systemic side effects [50]. …”

Section: Treatmentmentioning

confidence: 99%

Maintenance of Surgically Induced Remission of Crohn’s Disease

Froehlich¹,

Juillerat²,

Pittet³

et al. 2007

Digestion

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At 1 year after a first resection, up to 80% of patients show an endoscopic recurrence, 10–20% have clinical relapse, and 5% have surgical recurrence. Smoking is one of the most important risk factors for postoperative recurrence. Preoperative disease activity and the severity of endoscopic lesions in the neoterminal ileum within the first postoperative year are predictors of symptomatic recurrence. Mesalazine is generally the first-line treatment used in the postoperative setting but still provokes considerable controversy as to its efficacy, in spite of the results of a meta-analysis. Immunosuppressive treatment (azathioprine, 6-mercaptopurine) is based on scant evidence but is currently used as a second-line treatment in postsurgical patients at high risk for recurrence, with symptoms or with early endoscopic lesions in the neoterminal ileum. Nitroimidazole antibiotics (metronidazole, ornidazole) are also effective in the control of active Crohn’s disease in the postoperative setting. Given their known toxicity, they may be used as a third-line treatment as initial short-term prevention therapy rather than in the long term. Conventional corticosteroids, budesonide or probiotics have no proven role in postoperative prophylaxis. Infliximab has not as yet been studied for use in the prevention of relapse after surgery.

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Section: Treatmentmentioning

confidence: 99%

Maintenance of Surgically Induced Remission of Crohn’s Disease

Froehlich¹,

Juillerat²,

Pittet³

et al. 2007

Digestion

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“…By contrast, data related to the effect of infliximab therapy (rather than prophylaxis) for early endoscopic post surgical recurrence of CD are less consistent [5][6][7]. Such strategy would have clear cost and safety advantages over standard prophylaxis with the same drug [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Early Diagnosis and Treatment of Postoperative Endoscopic Recurrence of Crohn’s Disease: Partial Benefit by Infliximab—A Pilot Study

et al. 2012

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“…Literature about local injections of infliximab for extradermatological indications is increasing. It has essentially been used intralesionally in Crohn’s diseases [10,11,12] and in rheumatoid arthritis [13]. The first reports concern intra-articular infusion of the drug in inflammatory joint diseases and the last report to date is about intravitreal administration for neovascular age-related macular degeneration [14].…”

Section: Discussionmentioning

confidence: 99%

Intralesional Infliximab in Noninfectious Cutaneous Granulomas: Three Cases of Necrobiosis Lipoidica

et al. 2011

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Background: Necrobiosis lipoidica is a rare granulomatous noninfectious skin disease. Treatment of this chronic debilitating disease is of importance because ulceration of the plaques may induce important psychological and physical morbidity. Objective: Infliximab, an anti-TNF-α chimeric monoclonal antibody used intravenously and intralesionally for other extradermatological granulomatous diseases including Crohn’s disease and sarcoidosis, was administered by intradermal injection in necrobiosis lipoidica. The aim of this study was to evaluate the efficacy and safety profile of a locally delivered drug compared to its systemic use. Patients and Methods: Weekly injections of intralesional infliximab for 3 weeks were followed by a 1-week treatment interruption. This treatment schedule was repeated thrice. Results: Two patients who benefitted from complete treatment experienced almost complete remission for up to 18 months. The third patient, who had treatment interruptions, showed partial improvement. No serious side effects were noticed, although the injections caused pain. Conclusions: This is the first report about the efficacy and safety of a therapy consisting of intralesional injections of infliximab for a granulomatous skin disease. Although this approach was clearly effective for necrobiosis lipoidica, the disease recurred several months after treatment interruption, raising the question of the need for maintenance therapy. Further controlled long-term trials are thus necessary.

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Local injection of infliximab in the postoperative recurrence of Crohn's disease

Cited by 48 publications

References 32 publications

Maintenance of Surgically Induced Remission of Crohn’s Disease

Maintenance of Surgically Induced Remission of Crohn’s Disease

Early Diagnosis and Treatment of Postoperative Endoscopic Recurrence of Crohn’s Disease: Partial Benefit by Infliximab—A Pilot Study

Intralesional Infliximab in Noninfectious Cutaneous Granulomas: Three Cases of Necrobiosis Lipoidica

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