Infliximab: A novel chimeric monoclonal antibody for the treatment of Crohn's disease

Crohn's disease (CD) is characterized by transmural inflammatory disease in volving any portion of the gastrointestinal tract. Patients with CD have in creased mucosal concentrations of the cytokine tumor necrosis factor-alpha (TNF-alpha), a key mediator of mucosal inflammation. In addition, TNF-alpha has multiple biologic activities involved in apoptosis, metabolism, and ac tivation of granulocytes, lymphocytes, eosinophils, fibroblasts, chondrocyt es, and endothelial cells. Recently, infliximab has emerged as a novel chim eric monoclonal antibody that inhibits TNF-alpha. Infliximab is indicated f or the treatment of moderately to severely active CD in patients having an inadequate response to conventional therapy. To date, a small number of cli nical trials with infliximab have demonstrated efficacy and tolerability wh en the agent is initiated as a 5-mg/kg single intravenous infusion. In pati ents with fistulizing CD, administration of 2 subsequent 5-mg/kg doses 2 an d 6 weeks after the initial dose appears to be efficacious. Infliximab seem s to be a promising therapeutic strategy for patients with refractory CD.