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World J Gastroenterol. 2007 Apr 14;13(14):2089-93.

Crohn's disease, fatigue, and infliximab: is there a role for cytokines in the pathogenesis of fatigue?

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Department of Gastro-enterology, Univerisity Medical Centre Utrecht, Utrecht, The Netherlands.



To study the effect of infliximab on fatigue in relation to cytokine levels in Crohn's disease (CD) patients.


Fourteen CD patients were blinded for treatment and received placebo at baseline, and infliximab 2 wk later, with a follow-up of 4 wk. Blood samples were drawn on a regular basis, and questionnaires on fatigue, depression, quality of life, and clinical disease activity were completed at regular intervals.


After placebo infusion, fatigue scores decreased within 3 d (3.5 points +/- 1.1, P <or= 0.01), but returned to baseline values 14 d after this infusion. The drop of fatigue scores following infliximab infusion sustained until the end of the study (3.8 points +/- 1.4, P <or= 0.05). Quality of life was increased at the end of the study compared to baseline values (138.6 +/- 9.4 vs 179.4 +/- 6.7; P <or= 0.005), whereas depression scores were decreased (20.4 +/- 9.4 vs 11.3 +/- 2.2; P <or= 0.01). No correlation between the severity of fatigue and the level of cytokines was observed.


The reduction of fatigue after infliximab infusion is subjective to a placebo effect. The effect of infliximab on fatigue, however, persists while the placebo effect disappears after a short period of time. A clear role of cytokines could not be substantiated.

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