Efficacy of Infliximab in Crohn's Disease Patients with Prior Primary-Nonresponse to Tumor Necrosis Factor Antagonists

Digestive Diseases and Sciences
Kindra Dawn Clark-SnustadScott David Lee

Abstract

Tumor necrosis factor antagonists (TNFs) are effective for moderate-severe Crohn's disease (CD). Approximately one-third of patients have primary-nonresponse to TNFs, which is reported to predict worse response to subsequent TNF therapy. However, this is based on treatment with subcutaneously (SC) administered, fixed-dose TNFs after failure of intravenously (IV) administered, weight-based TNFs. No study has specifically assessed the clinical and endoscopic effectiveness of IV TNFs following primary-nonresponse to SC TNFs. We hypothesize that IV, weight-based TNF dosing offers advantages over SC, fixed-dose TNFs and may be effective despite primary-nonresponse to previous SC fixed-dose TNFs. This retrospective cohort study identified patients with moderate-severe CD with primary-nonresponse to one or more SC TNFs who subsequently received the IV TNF, infliximab for ≥ 12 weeks. We described baseline characteristics, and clinical, endoscopic and biochemical response to therapy. Key characteristics of 17 patients are described in Table 1. After ≥ 12 weeks of infliximab, 11 of 15 (73.3%) patients with clinical data reported clinical response and remission. Of 11 patients with endoscopic data, restaging colonoscopy revealed mucosal i...Continue Reading

References

Jun 6, 2002·Lancet·Stephen B HanauerUNKNOWN ACCENT I Study Group
May 2, 2007·Annals of Internal Medicine·William J SandbornPaul F Pollack
Jul 20, 2007·The New England Journal of Medicine·William J SandbornUNKNOWN PRECISE 1 Study Investigators
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Mar 17, 2016·Digestive Diseases·Zsuzsanna KurtiPeter Laszlo Lakatos
Mar 20, 2016·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·María Del Carmen R-GrauJavier P Gisbert

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