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Guidelines for treatment with infliximab for Crohn s disease Hommes DW; Oldenburg B; van Bodegraven AA; van Hogezand RA; de Jong DJ; Romberg-Camps MJ; van der Woude J; Dijkstra GNeth J Med 2006[Jul]; 64 (7): 219-29Infliximab is an accepted induction and maintenance treatment for patients with Crohn's disease. The effectiveness of infliximab has been demonstrated for both active luminal disease and for enterocutaneous fistulisation. In addition, infliximab can be administered for extraintestinal symptoms of Crohn's disease, such as pyoderma gangrenosum, uveitis and arthropathy. Maintenance treatment with infliximab is effective and is regarded as safe as long as the necessary safety measures are heeded. Infusion reactions occur in 3 to 17% of the patients and are associated with the formation of antibodies to infliximab. A reduction in infusion reactions is possible by the concurrent administration of steroids and the use of immunosuppressants (azathioprine, 6-mercaptopurine, methotrexate). Furthermore, immunosuppressants increase the duration of the response to infliximab. For these reasons, the concomitant use of immunosuppressants with infliximab is recommended. Infections and most specifically tuberculosis need to be ruled out before infliximab is administered. Up to now, there are no indications for a connection between an increased risk for malignancies and treatment with infliximab.|Algorithms[MESH]|Antibodies, Monoclonal/administration & dosage/adverse effects/immunology/*therapeutic use[MESH]|Clinical Trials as Topic[MESH]|Crohn Disease/complications/*drug therapy[MESH]|Dose-Response Relationship, Drug[MESH]|Drug Administration Schedule[MESH]|Gastrointestinal Agents/administration & dosage/adverse effects/immunology/*therapeutic use[MESH]|Humans[MESH]|Immune Tolerance/drug effects[MESH]|Infliximab[MESH]|Intestinal Fistula/drug therapy/etiology[MESH]|Patient Selection[MESH] |
