title: Infliximab maintenance therapy is associated with decreases in direct resource use in patients with luminal or fistulizing Crohn's disease.
abstract: OBJECTIVE
  To estimate the impact of infliximab (IFX) maintenance therapy on the use of hospital resources in patients with Crohn's disease (CD).
  
  
  METHODS
  Medical records of patients treated with IFX maintenance therapy (5 mg/kg body weight; intravenous infusion) for luminal (L) or fistulizing (F) CD at 13 hospitals were retrospectively reviewed. Patients were assessed as their own controls. Use of CD-related healthcare resources was recorded comparing 1-year periods before and after first IFX infusion (pre-IFX and post-IFX).
  
  
  RESULTS
  One hundred fifty-three CD patients (n=84 L; 69 F) fulfilled the inclusion criteria. Mean number of IFX infusions was 7/y with an average of 335 mg/infusion dose/patient. During the pre-IFX period, 55% of patients needed hospitalization versus 31% in the post-IFX period (P<0.001). Mean inpatient stay was 11.3 d/y [11.2 (L), 11.5 (F)] for the pre-IFX period, and 6.3 d/y [6.2 (L), 6.3 (F)] in the post-IFX period (P<0.001). Surgery was required in 24% patients in the pre-IFX period and in 11% post-IFX (P<0.001). There were no significant changes in the incidence of outpatient visits although emergency room visits fell significantly.
  
  
  CONCLUSIONS
  Maintenance IFX in CD patients is associated with decreases in the use and length of hospitalizations and the need for surgery in clinical practice.
authors.affiliation: Gastroenterology Department, Hospital Clínico San Carlos, Madrid, Spain. ctaxonera.hcsc@salud.madrid.org
authors.forename: Carlos
authors.initials: C
authors.lastname: Taxonera
authors.forename: Luis
authors.initials: L
authors.lastname: Rodrigo
authors.forename: Francesc
authors.initials: F
authors.lastname: Casellas
authors.forename: Xavier
authors.initials: X
authors.lastname: Calvet
authors.forename: Federico
authors.initials: F
authors.lastname: Gómez-Camacho
authors.forename: Daniel
authors.initials: D
authors.lastname: Ginard
authors.forename: Manuel
authors.initials: M
authors.lastname: Castro
authors.forename: Luisa
authors.initials: L
authors.lastname: Castro
authors.forename: Marta
authors.initials: M
authors.lastname: Ponce
authors.forename: Pilar
authors.initials: P
authors.lastname: Martínez-Montiel
authors.forename: Elena
authors.initials: E
authors.lastname: Ricart
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.forename: Antonio
authors.initials: A
authors.lastname: López-San Román
authors.forename: José M
authors.initials: JM
authors.lastname: Morales
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Casado
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab