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World J Gastroenterol. Mar 28, 2008; 14(12): 1885-1890
Published online Mar 28, 2008. doi: 10.3748/wjg.14.1885
Effect of infliximab on small bowel stenoses in patients with Crohn’s disease
Nadia Pallotta, Fausto Barberani, Naima Abdulkadir Hassan, Danila Guagnozzi, Giuseppina Vincoli, Enrico Corazziari
Nadia Pallotta, Fausto Barberani, Naima Abdulkadir Hassan, Danila Guagnozzi, Giuseppina Vincoli, Enrico Corazziari, Department of Clinical Science, University of Rome Sapienza; Rome COU Gastroenterology S. Camillo De Lellis Hospital Rieti, Rome 00168, Italy
Author contributions: Pallotta N and Corazziari E contributed equally to this work; Pallotta N and Corazziari E designed the research; Pallotta N, Barberani F and Hassan NA performed the research; Pallotta N, Vincoli G and Guagnozzi D analyzed the data; Pallotta N and Corazziari E wrote the paper.
Correspondence to: Professor Enrico Corazziari, Department of Scienze Cliniche, Università Sapienza, Policlinico Umberto I, Viale del Policlinico, Rome 00161, Italy. enrico.corazziari@uniroma1.it
Telephone: +39-6-49978384
Fax: +39-6-49978385
Received: September 20, 2007
Revised: January 19, 2008
Published online: March 28, 2008

AIM: To assess prospectively small bowel stenoses in Crohn’s disease (CD) patients treated with infliximab using Small Intestine Contrast Ultrasonography (SICUS).

METHODS: Twenty patients (M 12, age, 42.7 ± 11.8 years), 15 of whom showed obstructive symptoms indicating the presence of small bowel stenosis, and 5 without stenosis, were treated with infliximab (5 mg/kg at wk 0, 2, 6 and 5 mg/kg every 8 wk thereafter) for steroid refractoriness, fistulizing disease, or to avoid high-risk surgery. SICUS was performed at the induction phase and at regular time intervals during the follow-up period of 34.7 ± 16.1 mo (range 7-58). Small bowel stenoses were detected by SICUS, endoscopy and MRI.

RESULTS: In no case was progression of stenoses or the appearance of new ones seen. Of the 15 patients with stenosis, 5 stopped treatment after the induction phase (2 for no response, 3 for drug intolerance, one of whom showed complete regression of one stenosis). Among the remaining 10 patients, a complete regression of 8 stenoses (1 stenosis in 5 patients and 3 stenoses in one patient) was observed after 6-22 infliximab infusions.

CONCLUSION: In patients with CD treated with infliximab we observed: (a) No progression of small bowel stenosis and no appearance of new ones, (b) Complete regression of 1/22 stenosis after the induction phase and of 8/15 (53.3%) stenosis after 6-22 infusions during maintenance therapy.

Keywords: Crohn’s disease, Infliximab, Intestinal stenosis