Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study shows drug can heal, reduce recurrence of fistulas in Crohn’s disease

26.02.2004


An international study has found that maintenance therapy with the drug infliximab, a monoclonal antibody used to treat Crohn’s disease, can prevent or delay the recurrence of fistulas, a common complication of that inflammatory bowel disorder. As reported in the February 26 New England Journal of Medicine, patients receiving infliximab on a regular basis were twice as likely to avoid fistula recurrence than were patients receiving a placebo.



The study was largely supported by the pharmaceutical firm Centocor, a subsidiary of Johnson & Johnson, which markets infliximab under the brand name Remicade.

Crohn’s disease is a chronic inflammatory disorder of the digestive tract that affects about half a million people in the U.S. Patients with more severe symptoms may develop fistulas – openings from affected areas of the intestine into other organs or onto the skin, often around the anus. The presence of fistulas can seriously impact patients’ quality of life and increases the likelihood of surgical treatment, which may not have satisfactory results. Infliximab, which targets the inflammatory protein tumor necrosis factor, has been shown in previous research to reduce symptoms in patients without this complication and to heal fistulas over a limited period of time.


"Fistulas can be a devastating complication of Crohn’s disease," says Bruce Sands, MD, of the Massachusetts General Hospital (MGH) Gastrointestinal Unit, lead author of the report. "While neither medical nor surgical therapy is perfect in treating this complication, our study has shown that maintenance treatment with infliximab can produce durable closure of fistulas in many patients."

The current study – carried out at 45 sites in North America, Europe and Israel – enrolled adult patients with fistulizing Crohn’s disease not previously treated with infliximab. Almost 300 participants completed a preliminary phase of treatment, receiving three intravenous doses of infliximab over six weeks. They were evaluated several weeks later to determine whether they responded to the infliximab treatment – defined as a 50 percent or greater reduction in the number of draining fistulas – and subsequently randomized into groups receiving either continuing infliximab doses every eight weeks or placebo infusions. Neither participants nor the researchers knew to which groups patients were assigned.

Among participants who initially showed a response to infliximab, fistulas recurred much less frequently among those receiving continuing treatment than in the placebo group. At the end of the 54-week study, almost half those receiving infliximab still showed some response, with more than one-third remaining free of fistulas. Less than 20 percent of the placebo group stayed fistula-free during the same time period.

"The benefits of infliximab in this patient population go beyond closing of fistulas," Sands explains. "These patients also have a reduction in other symptoms and demonstrable improvement in their quality of life. While infliximab is not effective for all patients, the impact can be remarkable for those who do respond." Sands is an assistant professor of Medicine at Harvard Medical School.

The researchers also note that continuing treatment at fixed intervals appears superior to waiting until symptoms recur to reinstate therapy. Patients in the placebo group who redeveloped fistulas during the study could resume infliximab treatment, but although many experienced a renewed response to the medication, they all had to deal with worsening symptoms. Since infliximab does suppress part of the immune response, patients on sustained therapy should be followed closely for evidence of infection or other serious side effects.

Additional authors of the NEJM paper include senior author Sander van Deventer, MD, PhD, of Academisch Medisch Centrum, Amsterdam; Frank Anderson, MD, Vancouver Hospital; Charles Bernstein, MD, University of Manitoba; William Chey, MD, D.Sc., Rochester Institute for Digestive Diseases and Sciences; Brain Feagan, MD, University of Western Ontario; Richard Fedorak, MD, University of Alberta; Michael Kamm, MD, St. Mark’s Hospital, London; Joshua Korzenik, MD, Washington University School of Medicine; Bret Lashner, MD, Cleveland Clinic Foundation; Jane Onken, MD, Duke University; Daniel Rachmilewitz, MD, Tel Aviv Sourasky Medical Center; Paul Rutgeerts, MD, PhD, University Hospital Leuven, Belgium; Gary Wild, MD, PhD, Montreal General Hospital; and Douglas Wolf, MD, Atlanta Gastroenteroloy Associates. Co-authors from Centocor are Paul Masters, Susan Travers, MD, and Marion Blank, PhD.


Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $350 million and major research centers in AIDS, cardiovascular research, cancer, cutaneous biology, medical imaging, neurodegenerative disorders, transplantation biology and photomedicine. In 1994, MGH and Brigham and Women’s Hospital joined to form Partners HealthCare System, an integrated health care delivery system comprising the two academic medical centers, specialty and community hospitals, a network of physician groups, and nonacute and home health services.

Sue McGreevey | EurekAlert!
Further information:
http://www.mgh.harvard.edu/

More articles from Health and Medicine:

nachricht Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences

nachricht What does congenital Zika syndrome look like?
24.03.2017 | University of California - San Diego

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Argon is not the 'dope' for metallic hydrogen

24.03.2017 | Materials Sciences

Astronomers find unexpected, dust-obscured star formation in distant galaxy

24.03.2017 | Physics and Astronomy

Gravitational wave kicks monster black hole out of galactic core

24.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>