Infliximab is effective in closing fistulas in patients with Crohn’s disease.
Dr Lichtenstein and colleagues examined the effect of infliximab maintenance treatment on hospitalizations, surgeries, and procedures in patients with fistulizing Crohn’s disease enrolled in the ACCENT II study.
The researchers gave 5 mg/kg infliximab at weeks 0, 2, and 6 to a total of 282 patients.
At 14 weeks, 195 patients were separately randomized as responders, who showed at least a 50% reduction from baseline in the number of draining fistulas at both weeks 10 and 14.
The research team gave nonresponders placebo or 5 mg/kg infliximab maintenance every 8 weeks.
|Responders receiving infliximab had significantly fewer mean hospitalization days|
At week 22 and later, patients who lost response could be treated with a maintenance dose of 5 mg/kg higher.
The investigators compared data on Crohn’s disease-related hospitalizations, surgeries, and procedures between the treatment groups for responders and all randomized patients.
A total of 282 patients were randomized at week 14, of whom 195 were randomized as responders.
The investigators found that among patients randomized as responders, those who received infliximab maintenance had significantly fewer mean hospitalization days and mean numbers of hospitalizations.
In addition, the research team observed that responders receiving infliximab had fewer all surgeries and procedures, inpatient surgeries and procedures, and major surgeries compared with those who received placebo maintenance.
Dr Lichtenstein concludes, “In patients with fistulizing Crohn’s disease, infliximab 5 mg/kg every 8 weeks significantly reduced hospitalizations, surgeries, and procedures compared with placebo.”