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Effect of concurrent elemental diet on infliximab treatment for Crohn’s disease
Author(s) -
Tanaka Torao,
Takahama Kazuya,
Kimura Tomomi,
Mizuno Tamaki,
Nagasaka Mitsuo,
Iwata Katsumi,
Nakano Hiroshi,
Muramatsu Masaaki,
Takazoe Masakazu
Publication year - 2006
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2006.04317.x
Subject(s) - medicine , infliximab , crohn's disease , azathioprine , concomitant , gastroenterology , disease , elemental diet , enterocutaneous fistula , randomized controlled trial , surgery , parenteral nutrition , fistula
Background: Infliximab and elemental diet (ED) have been shown to be effective in the management of Crohn’s disease. However, few experiences have been reported regarding their combination therapy. The aim of the present study was to investigate the efficacy and safety of infliximab in Japanese patients, the first such study in Asia, as well as the effect of concomitant ED. Methods: One hundred and ten consecutive patients receiving infliximab were followed up to week 16 after the last infusion, and clinical response and primary outcome were collected. A response was defined as a reduction in Harvey–Bradshaw Index for inflammatory disease and closure of fistula in fistulizing disease. Results: Out of 75 inflammatory and 35 fistulizing disease patients, 68 (90.7%) and 25 (71.4%) responded at week 4, and 38 (50.7%) and 14 (40.0%) continued to respond until week 16, respectively. Interestingly, inflammatory disease patients with concurrent ED had a significantly higher response rate at week 16 (68.4%) than those without ED (32.4%, P = 0.0026). The effects of ED were independent of the usage of azathioprine and smoking habit. Conclusions: Infliximab was clinically useful in the treatment of Crohn’s disease in Japanese patients as well as in those in Western countries. The efficacy of concurrent ED was suggestive and should be confirmed in a randomized controlled study.