ABSTRACT
This is a preliminary study of resistant Crohn's disease treated with Infliximab [Remicade], a monoclonal antibody to Tumor necrosis factor alpha [TNF]. The aim of the study was to determine the efficacy of Infliximab in patients with moderate to severe active Crohn's disease. Material and The Prospective open label observational study was conducted in the department of Medicine and Gastroenterology Al Hammadi Hospital Riyadh Saudi Arabia from December 2000 to December 2001. Ten Patients with confirmed Crohn's disease of the bowel who had less than satisfactory response to conventional treatment were given Infliximab. Amongst the 10 patients 6 had luminal crohn's disease [60%] and 4 had fistulizing crohn's disease [40%]. Three patient had an associated extra intestinal manifestation of the disease, two having arthritis and an another had erythema nodosum. Out of 10 patients, 8 cases showed improvement in their disease [80%]. All the 4 cases with fistulising disease showed improvement in their disease with disappearance of the fistula in 3 cases. Patients with luminal crohn's disease 4 out of 6 improved clinically and in 2 cases there was no change in symptomatology. The arthritis and skin lesion resolved with improvement in bowel disease. Infliximab treatment is associated with remarkable clinical improvement in patients of crohn's disease with minimal adverse effects but further assessment of its long-term efficacy and safety needs to be determined