- Infliximab, starting a few weeks after bowel resection in patients with Crohn's disease (CD), reduces the risk for postoperative recurrence by approximately 50%-60% compared with placebo, according to a meta-analysis.
Why this matters
- More than 75% of patients with CD need surgical resection over the course of illness.
- Within 2-6 years of resection, 41% have clinical recurrence and 89% have endoscopic recurrence.
- Meta-analysis of 7 prospective placebo-controlled trials (n=455) after a search of Medline, EMBASE, PubMed, and Web of Science.
- Funding: National Natural Science Foundation of China; others.
- Infliximab (vs placebo) was associated with a 57.9% reduction in the risk for endoscopic recurrence (defined as Rutgeerts Score ≥2; relative risk [RR], 0.421; P<.001>
- Infliximab (vs placebo) was associated with a 48.1% reduction in the risk for clinical recurrence (RR, 0.519; P=.001). Clinical recurrence was defined as Hanauer >2, Crohn's Disease Activity Index >150, or Harvey-Bradshaw Index >8.
- The most common adverse events in infliximab-treated patients were lupus-like reaction, infusion reaction, bronchitis, nasopharyngitis, pyelonephritis, severe abdominal pain, and abdominal wall abscess.
- Small number of trials, patients.
- The term "prospective trials" was not defined, except that they were controlled.