Gastroenterology

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Crohn’s Disease: Immunogenicity of Infliximab Requires Attention

KEY POINT

Administration of single induction doses of infliximab (Remicade—Centocor) at times when patients with Crohn’s disease are not on immunosuppressive agents can lead to development of antibodies to the chimeric monoclonal antibody itself. When antibodies to infliximab (ATI) are present in high concentrations, patients have shortened duration of benefit, complete loss of response, and/or infusion reactions to infliximab.

SOURCES

Farrell RJ et al. Intravenous hydrocortisone premedication reduces antibodies to infliximab in Crohn’s disease: a randomized controlled trial. Gastroenterology. 2003;124:917–24.

Sandborn WJ. Preventing antibodies to infliximab in patients with Crohn’s disease: optimize not immunize [editorial]. Gastroenterology. 2003;124:1140–5.

Baert F et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. N Engl J Med. 2003;348:601–8.