Endoscopic and histological healing with infliximab anti-tumor necrosis factor antibodies in Crohn's disease: A European multicenter trial
| Autor: | S. J. H. Van Deventer, Paul Rutgeerts, C Kothe, Karel Geboes, R. A. van Hogezand, F Baert, DM Chalmers, T. F. Schaible, Geert D'Haens, T. Braakman |
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| Přispěvatelé: | Other departments |
| Jazyk: | angličtina |
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Colonoscopy Placebo Gastroenterology Severity of Illness Index Cohort Studies Crohn Disease Internal medicine Multicenter trial medicine Humans skin and connective tissue diseases Crohn's disease Hepatology biology medicine.diagnostic_test business.industry Tumor Necrosis Factor-alpha C-reactive protein Antibodies Monoclonal Endoscopy medicine.disease Crohn's Disease Activity Index Infliximab Surgery Europe C-Reactive Protein Treatment Outcome biology.protein Histopathology Female business medicine.drug |
| Zdroj: | Gastroenterology, 116(5), 1029-1034. W.B. Saunders Ltd |
| ISSN: | 0016-5085 |
| DOI: | 10.1016/s0016-5085(99)70005-3 |
| Popis: | Background & Aims: Tumor necrosis factor (TNF) is a pivotal cytokine in intestinal inflammation. Controlled trials using a chimeric anti-TNF antibody (infliximab) have shown its efficacy in refractory Crohn's disease. Methods: Endoscopic and histological response to infliximab was investigated in a multicenter, randomized, double-blind, and placebo-controlled trial including 30 patients with active Crohn's disease undergoing ileocolonoscopy before and 4 weeks after intravenous administration of 5, 10, or 20 mg/kg of infliximab or placebo as a single infusion. Lesions were scored by means of the validated Crohn's Disease Endoscopic Index of Severity (CDEIS). Endoscopic biopsy specimens were taken during both procedures from 9 of 30 patients and scored by a single gastrointestinal pathologist. Results: CDEIS scores decreased significantly in most infliximab-treated patients without an apparent dose response. No endoscopic improvement was observed in the placebo group. The changes in CDEIS correlated highly with those of the Crohn's Disease Activity Index. At a histological level, disappearance of the inflammatory infiltrate was observed in infliximab-treated patients but not in placebo-treated ones; however, architectural changes persisted in most patients. Strictures developed in several patients. Conclusions: Clinical improvement after infliximab therapy in active Crohn's disease is accompanied by significant healing of endoscopic lesions and disappearance of the mucosal inflammatory infiltrate. GASTROENTEROLOGY 1999;116:1029-1034 |
| Databáze: | OpenAIRE |
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