title: Therapeutic strategy for Crohn's disease with a loss of response to infliximab: a single-center retrospective study.
abstract: OBJECTIVE
  Infliximab (IFX) is an effective treatment for maintaining clinical remission in patients with initially moderate-to-severe Crohn's disease (CD). However, a certain number of patients become unresponsive to IFX, subsequently requiring intensified therapy. The aim of this study was to compare the short- and long-term therapeutic efficacy of intensified regimens in CD patients who fail to respond to IFX.
  
  
  METHODS
  The clinical courses of 33 CD patients who failed to respond to treatment with IFX were investigated retrospectively. An intensified regimen involving doubling the dose of IFX was chosen in 13 patients (DD group) versus shortening the IFX interval in 13 patients (SI group) and switching to adalimumab (ADA) in 7 patients (SA group).
  
  
  RESULTS
  The clinical response and rate of clinical remission at 4 weeks were 62 and 54% in the DD group, 77 and 62% in the SI group and 57 and 43% in the SA group, respectively (p = 0.59 for clinical response, p = 0.90 for clinical remission). The rate of sustained remission at 48 weeks was 44% in the DD group, 54% in the SI group and 33% in the SA group (p = 0.88).
  
  
  CONCLUSIONS
  The short- and long-term efficacy of doubling the dose of IFX, shortening the interval of IFX or switching to ADA is similar for CD patients who no longer respond to IFX.
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Yutaka
authors: Y
authors: Nagata
authors: Motohiro
authors: M
authors: Esaki
authors: Junji
authors: J
authors: Umeno
authors: Yuta
authors: Y
authors: Fuyuno
authors: Koji
authors: K
authors: Ikegami
authors: Yuji
authors: Y
authors: Maehata
authors: Kouichi
authors: K
authors: Asano
authors: Tomohiko
authors: T
authors: Moriyama
authors: Shotaro
authors: S
authors: Nakamura
authors: Takanari
authors: T
authors: Kitazono
authors: Takayuki
authors: T
authors: Matsumoto
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D003424:Crohn Disease / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D000069285:Infliximab; D060046:Maintenance Chemotherapy; D008297:Male; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069285:Infliximab; D000068879:Adalimumab