Effect of concurrent elemental diet on infliximab treatment for Crohn's disease.
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.
Tanaka
Torao
T
Department of Internal Medicine and Gastroenterology, Social Insurance Central General Hospital, Tokyo, Japan. toratanaka-gi@umin.ac.jp
Takahama
Kazuya
K
Kimura
Tomomi
T
Mizuno
Tamaki
T
Nagasaka
Mitsuo
M
Iwata
Katsumi
K
Nakano
Hiroshi
H
Muramatsu
Masaaki
M
Takazoe
Masakazu
M
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D003424:Crohn Disease / Q000178:diet therapy* / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005526:Food, Formulated; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab