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Topic infliximab injection for refractory rectal stenosis in Crohn’s disease: long-term follow-up in two patients
- Source :
- International Journal of Colorectal Disease. 32:1289-1294
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- TNF blockers are approved for intravenous or subcutaneous systemic therapy of many chronic inflammatory diseases. As it is not possible to achieve a sufficient local clinical improvement through systemic therapy in every patient, diverse approaches of topical therapy using TNF blockers have been investigated in recent years. In this paper, we report on long-term clinical results of originator infliximab (IFX) injections into symptomatic combined scarring and inflammatory stenoses of the rectum in two patients with Crohn’s disease. Aiming at high tissue IFX levels, 25 mg of IFX was injected into each quadrant of the stenosis after endoscopic balloon dilatation. This off-label treatment was repeated as necessary, depending on the clinical success. Topic IFX injection after balloon dilation reduced imperative stool pressure, isolated episodes of incontinence and incomplete emptying. Improvement lasted between 4 and 14 weeks in one patient and the treatment was repeated 13 times in the following 6.6 years. In the other patient, the technique was necessary only twice with no symptom recurrence in the subsequent 5.3 years. Our experience suggests that topic application of a systemically approved anti-TNF substance may be a successful individualized therapy for refractory stenosis of the rectum in patients with Crohn’s disease.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Anti-Inflammatory Agents
Rectum
Injections, Intralesional
03 medical and health sciences
Quadrant (abdomen)
0302 clinical medicine
Crohn Disease
Gastrointestinal Agents
Refractory
Recurrence
Internal medicine
medicine
Humans
Crohn's disease
business.industry
Gastroenterology
Colonoscopy
Hepatology
medicine.disease
Infliximab
Surgery
Stenosis
Rectal Diseases
Treatment Outcome
medicine.anatomical_structure
030220 oncology & carcinogenesis
Retreatment
Balloon dilation
Female
030211 gastroenterology & hepatology
business
Intestinal Obstruction
medicine.drug
Subjects
Details
- ISSN :
- 14321262 and 01791958
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- International Journal of Colorectal Disease
- Accession number :
- edsair.doi.dedup.....3890352fd956902758537923e7bb6a1e