title: Infliximab prevents Crohn's disease recurrence after ileal resection.
abstract: OBJECTIVE
  Crohn's disease commonly recurs after intestinal resection. We evaluated whether the administration of infliximab after resective intestinal surgery for Crohn's disease reduces postoperative recurrence.
  
  
  METHODS
  We randomly assigned 24 patients with Crohn's disease who had undergone ileocolonic resection to receive intravenous infliximab (5 mg/kg), administered within 4 weeks of surgery and continued for 1 year, or placebo. The primary end point was the proportion of patients with endoscopic recurrence at 1 year. Secondary end points were clinical recurrence and remission and histologic recurrence.
  
  
  RESULTS
  The rate of endoscopic recurrence at 1 year was significantly lower in the infliximab group (1 of 11 patients; 9.1%) compared with the placebo group (11 of 13 patients; 84.6%) (P = .0006). There was a nonsignificant higher proportion of patients in clinical remission in the infliximab group (8 of 10; 80.0%) compared with the placebo group (7 of 13; 53.8%) (P = .38). The histologic recurrence rate at 1 year was significantly lower in the infliximab group (3 of 11 patients; 27.3%) compared with the placebo group (11 of 13 patients; 84.6%) (P = .01). The occurrence of adverse events was similar between the placebo and infliximab groups, and none occurred in the immediate postoperative period.
  
  
  CONCLUSIONS
  Administration of infliximab after intestinal resective surgery was effective at preventing endoscopic and histologic recurrence of Crohn's disease.
authors.affiliation: Inflammatory Bowel Disease Center and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA. mdr7@pitt.edu
authors.forename: Miguel
authors.initials: M
authors.lastname: Regueiro
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schraut
authors.forename: Leonard
authors.initials: L
authors.lastname: Baidoo
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.forename: Antonia R
authors.initials: AR
authors.lastname: Sepulveda
authors.forename: Marilyn
authors.initials: M
authors.lastname: Pesci
authors.forename: Janet
authors.initials: J
authors.lastname: Harrison
authors.forename: Scott E
authors.initials: SE
authors.lastname: Plevy
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D053704:Capsule Endoscopy; D003106:Colon / Q000473:pathology; D003113:Colonoscopy; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000097:blood / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology / Q000601:surgery*; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D002097:C-Reactive Protein; D000069285:Infliximab