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Treatment options for people with Crohn's disease include intravenous infusions of infliximab, which blocks tumor necrosis factor, an important cause of inflammation in Crohn's disease. Another treatment, azathioprine, is taken orally, and suppresses the immune system.
In a study funded by Centocor Inc., the company that manufactures Remicade, researchers studied 508 people with moderate to severe Crohn's disease.
They found that infliximab alone or in combination with azathioprine was a statistically more effective treatment than azathioprine alone. Specifically, 57% of patients who received combination therapy and 44% of those who received infliximab alone achieved steroid-free remission after 26 weeks, compared with 30% of patients who received azathioprine alone.
"Historically, patients with Crohn's disease have been treated sequentially with steroids, then azathioprine, then monoclonal antibodies such as infliximab. This study definitively demonstrates that infliximab-based strategies are more effective than azathioprine," lead author William Sandborn, a gastroenterologist at the Mayo Clinic, said in a clinic news release. "Clinicians should consider a shift in practice to incorporate this new data."
In addition, 61% of the patients who received combination therapy also experienced bowel healing. This is important, since bowel healing is associated with a reduced risk of hospitalization and surgery.
"Our goal with this study was to determine if infliximab-based treatment strategies were safe and more effective than treatment with azathioprine in these patients," said Sandborn. "For patients, this new therapy is an opportunity for remission and a significant improvement in quality of life."
-- Krisha McCoy
SOURCE: Mayo Clinic, news release, Oct. 6, 2008
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