Effect of Infliximab in the Treatment of Refractory Inflammatory Bowel Disease with Complication

Abstract

Background/Aims: Many studies on infliximab have confirmed its efficacy in the remission induction and even

maintenance in refractory and fistulizing Crohn's disease. We report the treatment efficacy of infliximab in

Crohn's disease and ulcerative colitis refractory to steroid treatment and the complications of infliximab treatment.

Methods: We performed infliximab administration in 5 cases (3 Crohn's disease, 2 ulcerative colitis) refractory

to systemic steroid treatment and 5 cases of Crohn's disease with fistula. Patients received an intravenous infusion

of infliximab at 3-5 mg/kg body weight. Results: In 3 cases of refractory Crohn's patients, clinical response and

remission induction were obtained in 2 (67%) and 1 cases (33%). After infusion of infliximab, the occlusion of

internal fistula could be found in all 2 cases. Two out of 3 cases of anal fistula were completely healed. In two

cases of refractory ulcerative colitis, one case who showed clinical manifestation of toxic megacolon had improved

and avoided the colectomy, but the other case did not respond to the infusion of infliximab and underwent colon

resection. Conclusions: We found that administration of infliximab is an effective alternative for refractory and

fistulizing Crohn's disease but further studies are necessary for refractory ulcerative colitis.