title: Use of infliximab in particular clinical settings: management based on current evidence.
abstract: With the increasingly widespread use of the anti-tumor necrosis factor-alpha agent infliximab for the treatment of Crohn's disease and ulcerative colitis, there have been some concerns raised about the potential consequences of such therapy in particular clinical settings. In this review, we report the current strategies for optimizing treatment outcomes and minimizing the risks of some of the most serious events attributable to infliximab therapy. In particular, an up-to-date overview is provided on how to treat patients with inflammatory bowel disease using infliximab therapy, with regard to the diagnosis and management of latent tuberculosis infection and the risk of reactivation of hepatitis B and C infections. Furthermore, based on the available evidence, we evaluate the possibility of using infliximab during pregnancy. Finally, we evaluate whether patients with malignancies or pre-neoplastic lesions could be candidates for infliximab therapy. Overall, this review will provide physicians who use infliximab for the treatment of inflammatory bowel disease with several practical recommendations for the management of some complex situations that may occur in daily clinical practice.
authors.affiliation: Gastroenterology Unit, Department of Internal Medicine, Catholic University of Rome, Largo A. Gemelli 8, Rome, Italy. apapa@rm.unicatt.it
authors.forename: Alfredo
authors.initials: A
authors.lastname: Papa
authors.forename: Giammarco
authors.initials: G
authors.lastname: Mocci
authors.forename: Michele
authors.initials: M
authors.lastname: Bonizzi
authors.forename: Carla
authors.initials: C
authors.lastname: Felice
authors.forename: Gianluca
authors.initials: G
authors.lastname: Andrisani
authors.forename: Italo
authors.initials: I
authors.lastname: De Vitis
authors.forename: Luisa
authors.initials: L
authors.lastname: Guidi
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D006801:Humans; D000069285:Infliximab; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000592:standards; D017410:Practice Guidelines as Topic
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab