Fig 1.
Patients subjected to prophylactic infliximab [IFX] 5 mg/Kg after surgery and in full remission after 3 years of therapy showed endoscopic recurrence in 83% of cases when the medication was stopped. Those with recurrence (n = 10) re-started IFX in a dose optimization study in which we showed that 3 mg/Kg were sufficient to re-induce and maintain endoscopic remission for 1 year in all patients (ref.2). Five of these ten patients participated in the current study. Antibodies To Infliximab [ATI] and Infliximab Trough Levels [ITL] were measured and compared to those of CD patients who did not undergo surgery in remission on a standard 5 mg/Kg IFX dose. After an additional 18 months the patients treated with 3 mg/Kg IFX underwent colonoscopy.
Table 1.
Patient features at enrollment.
Fig 2.
Infliximab concentration (A), Highly Sensitive [HS]–CRP (B) and Fecal Calprotectin (C) during infliximab therapy.
Empty long dash lines: control patients (treated with infliximab 5 mg/Kg); Filled lines: study subjects (treated with infliximab 3 mg/Kg). Square dot lines indicate the upper limit of the normal range for HS-CRP and Fecal Calprotectin. Values are reported as mean and standard error (vertical bars). The asterisk denotes a significant difference (p < 0.05) between controls and study subjects at a given time point during the 8-week therapeutic interval.
Table 2.
ITL and ATI in patients treated with infliximab 3 mg/Kg and controls.
Fig 3.
Endoscopy (neo-terminal ileum) after a total of 30 months of therapy with infliximab 3 mg/Kg.
Rutgeerts scores were identical to baseline (baseline: one year of treatment with infliximab 3 mg/Kg): 0,1,1,1,0 in patients #1,#2,#3,#4,#5 listed in Table 1, respectively (A-E).