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Aliment Pharmacol Ther. 2011 Apr;33(8):857-69. doi: 10.1111/j.1365-2036.2011.04598.x. Epub 2011 Feb 15.

Review article: infliximab for Crohn's disease treatment--shifting therapeutic strategies after 10 years of clinical experience.

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1
Division of Gastroenterology, Instituto Clinico Humanitas, IRCCS in Gastroenterology, Via Manzoni 56, Rozzano, Milan, Italy. sdanese@hotmail.com

Abstract

BACKGROUND:

Crohn's disease is a progressive condition, with most patients developing a penetrating or stricturing complication over time. A decade ago, treatment goals consisted of immediate symptomatic control. The introduction of anti-tumour necrosis factor (anti-TNF) therapies, however, has changed the way patients with Crohn's disease are treated. Over 10 years of clinical data and experience have demonstrated these therapies to be highly effective in Crohn's disease.

AIM:

To provide clinicians guidance on optimising treatment with anti-TNF therapies in Crohn's disease by introducing an evidence- and personal opinion-based treatment algorithm using infliximab initial anti-TNF therapy.

METHODS:

Scientific literature was reviewed using MEDLINE to evaluate data on clinical trials with infliximab in luminal and fistulising Crohn's disease.

RESULTS:

The data from several landmark infliximab trials have changed clinical practice and led to a readjustment of treatment goals in Crohn's disease, allowing patients to achieve more than just symptomatic relief including sustained steroid-free remission. Infliximab induces complete mucosal healing and reduces the rates of hospitalisation and surgery. Based on disease-related risk factors, a treatment algorithm for infliximab is delineated in favour of a rapid step-up approach in patients at high risk for a disabling course of disease.

CONCLUSION:

Adopting the suggested treatment algorithm for infliximab into clinical routine is aimed to optimise outcomes for patients with Crohn's disease.

[Indexed for MEDLINE]
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