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The emergence of infliximab, a cytokine-directed biologic therapy, represents a significant advancement in the understanding of the pathophysiology and treatment of the inflammatory bowel disorder, Crohn’s disease. Therapy with the chimeric monoclonal antibody allows for the precise blockage and neutralization of tumour necrosis factor-alpha, a key cytokine responsible for bowel mucosal inflammation. Clinical efficacy of infliximab in patients with intractable Crohn’s diseases has been conclusively shown in several acute studies, and a long-term study (multiple infusions) suggests benefit for maintenance of the effect in patients with severe disease. Clinical benefits with infliximab therapy were characterized by a rapid reduction of the signs and symptoms of Crohn’s disease, a decrease of inflammation in the bowel (observed both endoscopically and histologically) with induction of mucosal healing, and improvement in patients’ quality of life. In patients with the disease complicated by fistulization, infliximab demonstrated rapid onset of fistulae closure (usually within 2 weeks) with a lasting median benefit of action (exceeding 3 months). The chimeric monoclonal antibody was well tolerated in the short term; serious adverse events were infrequent, without sequelae, and were successfully managed with medications. As with most biologic therapeutics, treatment with infliximab will continue to present challenges. Clinical issues regarding the pharmacoeconomics of infliximab, its use in appropriate patient populations, its use as sequential or concomitant treatment with conventional therapy, its potential long-term toxicities, and its ability to ‘reset’ the mucosal immune system remain areas of continued investigation. Although further research is required, clinicians now have a novel approach for treating Crohn’s disease, which affects both patient outcome and their quality of life.