CLINICAL AND ENDOSCOPIC HEALING AFTER INFLIXIMAB TREATMENT IN PATIENTS WITH CROHN's DISEASE

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Background: Intestinal mucosal lesions in Crohn's disease were endoscopically evaluated before and after giving infliximab, and the usefulness of this treatment was investigated. Patients and methods: The present study included 12 patients with active Crohn's disease who could undergo colonoscopy before and after giving infliximab. (i) The treatment assessment consisted of evaluations of short‐term and long‐term therapeutic effects. The clinical evaluation was conducted using the Crohn's disease activity index (CDAI). The results of the clinical evaluation were compared with those of the colonoscopic evaluation. (ii) The endoscopic evaluation findings were divided into polyposis, ulcer and stenosis, and the area ranging from the rectum to the terminal ileum. The scores for the findings at seven sites were totaled. In the short‐term therapeutic effect, characteristics of ulcer morphology and background factors were investigated endoscopically. Results: (i) The efficacy rate was 92% clinically and 67% endoscopically in the evaluation of short‐term therapeutic effects. The efficacy rate was 86% clinically and 86% endoscopically in the evaluation of long‐term therapeutic effects. (ii) On the endoscopic evaluation, the ulcer score was significantly (P = 0.03) improved after giving infliximab, while there was no remarkable change in the polyposis score and the stenosis score tended to worsen. On the evaluation of therapeutic effects based on ulcer morphology, infliximab was endoscopically effective in patients with longitudinal ulcers. On the evaluation of therapeutic effects based on background factors, the treatment was effective in patients given a combination of infliximab and immunosuppressants. Conclusion: The ulcerative lesions were found to be markedly improved, but the intestinal stenosis tended to worsen, after giving infliximab. It is necessary that the severity of intestinal stenosis be adequately understood before giving infliximab. Giving immunosuppressants should be used for combined treatment.

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