Scheduled maintenance treatment with infliximab is superior to episodic treatment for the healing of mucosal ulceration associated with Crohn's disease

Rutgeerts, Paul; Diamond, Robert H.; Bala, Mohan; Olson, Allan; Lichtenstein, Gary R.; Bao, Weihang; Patel, Kamlesh B.; Wolf, Douglas C.; Safdi, Michael; Colombel, Jean Fréd́eric; Lashner, Bret A.; Hanauer, Stephen B.

doi:10.1016/j.gie.2005.08.011

Cited by 503 publications

(318 citation statements)

References 25 publications

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“…Active inflammation in CD is treated with systemic corticosteroids alone or in combination with other immune-modulator drugs (12)(13)(14). Remission therapy uses other nonsteroidal immune-modulator drugs.…”

Section: Discussionmentioning

confidence: 99%

Role of spectral presaturation attenuated inversion‐recovery fat‐suppressed T2‐weighted MR imaging in active inflammatory bowel disease

Udayasankar

Martín

Lauenstein

et al. 2008

Magnetic Resonance Imaging

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Purpose:To retrospectively evaluate the efficacy of spectral presaturation attenuated inversion-recovery (SPAIR) fatsuppressed (FS) partial Fourier single shot (SSH) T2-weighted (T2W) and gadolinium-enhanced (Gd) FS 3D-gradient echo (3DGRE) T1-weighted (T1W) delayed phase MRI to differentiate active bowel inflammation from fibrotic disease in patients with Crohn's disease (CD). Materials and Methods:MRI studies of 81 patients (mean age, 43 years; range, 22-77 years; M:F ratio 33:48) had T2W and T1W imaging including SPAIR-SSH and delayed Gd-3DGRE. The ability to assess disease activity in bowel segments affected were retrospectively evaluated by a grading scheme based on subjective analysis of signal intensities. These results were compared against the standard clinical parameters of disease activity.Results: SPAIR-SSH images correlated better (r ϭ 0.74, P Ͻ 0.0001) with activity than delayed Gd-3DGRE (r ϭ 0.39, P ϭ 0.0003), with a significant difference between the two techniques (P Ͻ 0.0001). SPAIR-SSH images showed higher specificity in detection of severely active disease in per patient (98%) and segmental (98%) analysis compared to Gd-3DGRE (57%, 70%). Gd-3DGRE technique showed significantly higher sensitivity (P ϭ 0.01) in identifying active disease in per patient (83%) and segmental (85%) analysis compared to SPAIR-SSH (70%, 64%).Conclusion: SPAIR-SSH detects actively diseased CD bowel segments with a high level of specificity. Noninflammatory bowel fibrosis corresponds to abnormal uptake on delayed phase Gd-3DGRE images but without associated elevated abnormal signal on SPAIR-SSH.

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Section: Discussionmentioning

confidence: 99%

Role of spectral presaturation attenuated inversion‐recovery fat‐suppressed T2‐weighted MR imaging in active inflammatory bowel disease

Udayasankar

Martín

Lauenstein

et al. 2008

Magnetic Resonance Imaging

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“…It must taken into consideration that the registry started when only episodic infl iximab therapy was FDA approved. Several years, hence, infl iximab was approved for both induction and maintenance therapies ( 14,15 ), which reduced immuno genicity to infl iximab and the risk of infusion reactions ( 16 ).…”

Section: Conflict Of Interestmentioning

confidence: 99%

Editorial: What to Take From TREAT?

Hanauer

2012

American Journal of Gastroenterology

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The TREAT Registry is an updated submission of the 5-year follow-up of Crohn ' s disease patients from community and academic centers in North America treated with or without infl iximab. Over 6,000 patients were followed for risks of mortality and serious infections. Similar to data presented after nearly 2 years of follow-up, mortality was similar for infl iximaband other-treatment-only patients. Infl iximab, corticosteroids and narcotics were associated with increased risks of serious infections. Data presented is similar from data reported for controlled trials and observational series in patients with infl ammatory bowel disease and rheumatoid arthritis.

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“…The mainstay of treatment for IBD is inducing and maintaining disease remission. New therapeutic goals also involve achieving mucosal healing, which has been shown to lead to improved clinical outcomes, including lower rates of surgical intervention [1][2][3]. Once an uncommon disease entity in Asia, the incidence of IBD is on the rise [4,5], and its severity in Asia can be equal to or greater than that in the West.…”

Section: Introductionmentioning

confidence: 99%

Emerging biologics in inflammatory bowel disease

Chan

2016

J Gastroenterol

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Early biologic therapy is recommended in patients with inflammatory bowel disease and poor prognostic factors and in those refractory to conventional medications. Anti-tumor necrosis factor (anti-TNF) agents are the most commonly used biologic agents. However, some patients may not have an initial response to anti-TNF therapy, and one-third will develop loss of response over time. Anti-TNF drugs can also be associated with side effects. In addition, the use of biologics is currently limited by their cost, especially in developing countries. A number of new therapeutic targets, including novel small molecules, and cellular therapy are available or under investigation. These novel molecules include oral Janus kinase (JAK) inhibitor (tofacitinib), interleukin inhibitor (ustekinumab), oral SMAD7 antisense oligonucleotide (mongersen), and anti-integrin inhibitors (vedolizumab). Here, we review the mechanisms of action, the efficacy, and the safety data of these novel agents. Biological products that are highly similar to reference biologic products whose patents have expired-also known as ''biosimilars''-can be produced at lower cost with similar efficacy, and are also available for the treatment of IBD. We review the efficacy data for such agents as well.

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Scheduled maintenance treatment with infliximab is superior to episodic treatment for the healing of mucosal ulceration associated with Crohn's disease

Cited by 503 publications

References 25 publications

Role of spectral presaturation attenuated inversion‐recovery fat‐suppressed T2‐weighted MR imaging in active inflammatory bowel disease

Role of spectral presaturation attenuated inversion‐recovery fat‐suppressed T2‐weighted MR imaging in active inflammatory bowel disease

Editorial: What to Take From TREAT?

Emerging biologics in inflammatory bowel disease

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