Infliximab for Crohn's disease in clinical practice at the mayo clinic: The first 100 patients

OBJECTIVE: The aim of this study was to report the clinical outcome and adv erse events in the first 100 patients with refractory inflammatory and/or f istulizing Crohn's disease treated with infliximab at the Mayo Clinic. METHODS: Patient data was abstracted from medical records. Clinical respons e was classified as complete response, partial response, and nonresponse. RESULTS: Indications for infliximab therapy were: inflammatory disease (61 patients), fistulizing disease (26 patients), or both (13 patients). Patien ts received one to seven infusions of infliximab (5 mg/kg) for a total of 2 42 infusions. In all, 50 patients had complete response, 22 had partial res ponse, and 28 had nonresponse. Median time to response was 7 days (range 1- 21 days). Median duration of response was 10.3 weeks (range 3-25 wk). A tot al of 95 patients received concomitant treatment with immune modifiers. Ste roid withdrawal was possible in 29/40 patients (73%). Median time of follow -up was 34 wk (range 14-48 wk). Clinically significant adverse events after infliximab included: abscess formation in two patients (perianal, peristom al), pneumonia in two patients, varicella tester in three patients, candida esophagitis in one patient, and infusion-related reactions in 19 patients. A total of 23 patients were continued on infliximab as maintenance treatme nt. CONCLUSIONS: This study provides additional evidence that infliximab is saf e and beneficial in clinical practice for refractory Crohn's disease. (C) 2 001 by Am. Cell. of Gastroenterology.