Clinical use of Infliximab in Crohn's disease: the Edinburgh experience

Aliment Pharmacol Ther. 2001 Oct;15(10):1639-46. doi: 10.1046/j.1365-2036.2001.01092.x.


Infliximab is an established treatment for steroid-resistant and fistulating Crohn's disease. Although efficacy has been shown in clinical trials, financial implications often limit its use and limited data exist regarding clinical practice.

Aims: To audit the clinical effectiveness of Infliximab.

Methods: We prospectively audited 50 consecutive patients [28 females; median age, 34 years (17-70 years)]. Disease activity and response rates were assessed by the Harvey-Bradshaw index. Clinical and disease data were collected and blood was taken for inflammatory markers, complement and double-stranded DNA antibodies. Patients received Infliximab at 5 mg/kg and were followed for 12 weeks.

Results: Indications for Infliximab were refractory Crohn's disease in 39 patients, fistulating Crohn's disease in six, pyoderma gangrenosum in one, pouchitis in two and coeliac disease in two. Thirty-one (79%) of the refractory Crohn's disease patients and four (66%) of the fistulating patients responded at 4 weeks. Twenty-one (54%) of the refractory Crohn's disease patients had a continued response at 12 weeks. Perianal disease was more prevalent in non-responders (7/8 vs. 12/31, P < 0.02).

Conclusions: Response rates to Infliximab in our group are comparable to those of clinical trials. Despite the expense, it remains a useful adjunct to treatment in this otherwise difficult group of patients. Patients with perianal disease responded less well in our cohort.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Biomarkers
  • Celiac Disease / drug therapy
  • Cohort Studies
  • Crohn Disease / complications
  • Crohn Disease / drug therapy*
  • Drug Therapy, Combination
  • Female
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Infliximab
  • Intestinal Fistula / drug therapy
  • Intestinal Fistula / etiology
  • Male
  • Middle Aged
  • Pouchitis / diagnosis
  • Pouchitis / drug therapy
  • Prognosis
  • Prospective Studies
  • Pyoderma Gangrenosum / diagnosis
  • Pyoderma Gangrenosum / drug therapy
  • Steroids
  • Treatment Outcome


  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Biomarkers
  • Gastrointestinal Agents
  • Steroids
  • Infliximab