Remicade Fights Crohn's Disease Complications

Feb. 26, 2004 -- Prolonged treatment with the drug Remicade may help some people with Crohn's disease prevent a common but potentially dangerous complication of their condition.

 

A new study shows people with Crohn's disease who have a good initial response to treatment with the drug are also likely to benefit from long-term treatment with Remicade. Researchers found this group of patients was also twice as likely to avoid fistula recurrence than those who took a placebo.

 

Crohn's disease is an inflammatory disorder of the digestive tract that affects about half a million people in the U.S. It's a chronic condition that causes symptoms such as diarrhea and abdominal pain.

 

People with more severe forms of the disease may also develop fistulas or openings from affected areas of the intestine into other organs or on to the skin, such as around the anus. The presence of fistulas negatively affects the patient's quality of life and increases the need for surgery.

 

"Fistulas can be a devastating complication of Crohn's disease," says researcher Bruce Sands, MD, of Massachusetts General Hospital, in a news release. "While neither medical nor surgical therapy is prefect in treating this complication, our study has shown that maintenance treatment with [Remicade] can produce durable closure of fistulas in many patients."

 

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Remicade Fights Fistulas

In the study, published in the Feb. 26 issue of the New England Journal of Medicine, researchers looked at the effects of Remicade in 306 people with Crohn's disease who had not previously been treated with the drug.

 

Everyone was given an initial treatment of three doses of Remicade delivered by injection over six weeks. Several weeks later, a total of 195 of these patients had responded to the drug and 87 had not. The entire group was then randomly divided into two groups that either continued treatment with Remicade or received a placebo once every eight weeks.

 

A little more than a year after the treatment began, the study showed that those who initially responded well to Remicade continued to benefit from the drug. By the end of the 54-week study, 36% of those on Remicade remained free of fistulas compared with only 19% of those on the placebo.

 

In addition, researchers also found that people in the placebo group who had initially responded to the drug but had discontinued therapy also benefited from resuming treatment with Remicade.

 

"The benefits of [Remicade] in this patient population go beyond closing of fistulas," says Sands. "These patients also have a reduction in other symptoms and demonstrable improvement in their quality of life. While [Remicade] is not effective for all patients, the impact can be remarkable for those who do respond."

 

Researchers say that since Remicade suppresses part of the immune system, people on long-term treatment with the drug should be monitored closely for evidence of infection or other side effects.