Arthritis drug fights Crohn’s disease

The inflammation-fighting drug infliximab, which has shown promise against acute attacks of Crohn’s disease, can hold off the intestinal ailment for a full year in many patients, an international group of researchers now report in the May 4 Lancet.

Not all people with Crohn’s disease–marked by pain, diarrhea, and weight loss–respond to infliximab, which is mainly used against rheumatoid arthritis. Researchers identified 355 Crohn’s patients in North America, Europe, and Israel who responded to a single dose and then enrolled them in a trial to test the drug’s long-term effectiveness.

The patients were randomly divided into three groups. Some received a single intravenous infusion of infliximab, also called Remicade, and subsequent doses of an inert substance. Two other groups received an infusion of infliximab at the start, additional doses 2 and 6 weeks later, and further doses every 2 months for the remainder of a year. One of these groups got double doses beginning in the third month.

After 30 weeks, the disease was in remission in 21 percent of the group getting a single dose followed by placebos. The rate was 39 percent in the patients receiving a single dose bimonthly and 45 percent in the double-dose group.

There is no known cure for Crohn’s disease; the symptoms are usually treated with steroids and other anti-inflammatory drugs. The new findings suggest that infliximab’s effectiveness against chronic Crohn’s disease might enable some patients to lessen or stop their use of steroids and avoid serious side effects, say study coauthor Stephen B. Hanauer of the University of Chicago Medical Center and his colleagues.

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