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Infliximab in crohn's disease: clinical experience from a single tertiary center of Sao Paulo State

INTRODUCTION: In Crohn's Disease (CD) occurs an abnormal reactivity of T lymphocytes of intestinal mucosa and an exceeding production of proinflammatory cytokines, such as the tumor necrosis factor- alpha (TNF-á). Infliximab is a monoclonal antibody against TNF-á, indicated for treatment of patients with fistulizing or refractory CD. OBJECTIVES: To characterize the clinical indications of infliximab in CD at a referral center of Sao Paulo State, assessing patterns of response and treatment effectiveness by Crohn's Disease Activity Index (CDAI). PATIENTS AND METHODS: This was an observational, retrospective study; data of 21 patients with CD receiving infliximab therapy at Hospital de Base de Rio Preto between January 2004 and July 2008 were analyzed. RESULTS: Female patients were predominant (67%) and mean age was 33 years. Perianal fistulas represented the most common indication for infliximab use (48%). Complete clinical response to drug occurred in 43% of patients, and partial response in 47%; the mean difference of CDAI between the groups, before and after infliximab treatment, was 244.61 points (p< 0.0005). CONCLUSIONS: Infliximab induced clinical improvement in 90% of patients, with concomitant reduction of disease activity as measured by a standardized index.

Inflammatory enteropathy; Crohn's Disease; Tumor Necrosis Factor -alpha; Antibodies, Monoclonal; Clinical evolution


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