Infliximab in the treatment of extra-intestinal manifestations of Crohn's disease.
BACKGROUND
Crohn's disease (CD) is frequently associated with extra-intestinal manifestations (EIMs) and infliximab has been recently proposed for the treatment of CD with EIMs. Our aim was to evaluate the short-term efficacy of infliximab in this treatment.


METHODS
Thirty CD patients were treated with infliximab. Fifteen patients (50%) showed EIMs before starting therapy. Ten patients presented an arthritis (five sacroiliitis, five spondylitis), with six also reporting peripheral arthralgias. Four patients presented cutaneous EIMs while three patients had an ocular EIM.


RESULTS
At week 10, all patients reported an improvement in EIMs. Regarding arthritis, ASAS20 and ASAS40 improvement was observed in 80% and 60% of patients, respectively. In the four patients with cutaneous EIMs and in the three with ocular EIMs, complete healing was observed. Recurrence was observed in 10 out of 15 patients (66%) and a second course of treatment with infliximab was required. This proved to be effective in all cases except for one patient who stopped treatment because of a severe adverse reaction.


CONCLUSIONS
Infliximab is an effective drug in the short-term treatment of EIMs complicating CD. Although relapse of EIMs occurs frequently, retreatment ensures effective control of the symptoms.
Rispo
A
A
Department of Gastroenterology, University Federico II of Naples, Italy. antoniorispo@email.it
Scarpa
R
R
Di Girolamo
E
E
Cozzolino
A
A
Lembo
G
G
Atteno
M
M
De Falco
T
T
Lo Presti
M
M
Castiglione
F
F
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D018771:Arthralgia / Q000188:drug therapy / Q000209:etiology; D001168:Arthritis / Q000188:drug therapy* / Q000209:etiology*; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017511:Pyoderma Gangrenosum / Q000188:drug therapy / Q000209:etiology; D013166:Spondylitis / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000069285:Infliximab