Drug combination works for severe Crohn’s disease
By Lilian Anekwe
The combination of azathioprine and infliximab is considerably more effective than either drug in its own in patients with moderate-to severe Crohn's diseases according to results from an international trial.
Researchers recruited 169 patients from 92 centres in the US and Europe to receive either infliximab plus placebo, azathioprine plus placebo or the combination for at least 30 weeks.
At week 26 59% of patients taking the combination were in corticosteroid-free remission compared to 44% on infliximab and just 30% on azathioprine.
Mucosal healing had occurred in 44% on combination, 30% on infliximab and 16% on azathioprine
NICE recommends infliximab only be used in patients with severe disease who are refractory to azathioprine.
But study leader Professor William Sandborn, professor of medicine at the Mayo Clinic in Rochester said: ‘Treatment guidelines generally recommend reserving anti-TNF therapies for when conventional therapies have failed but combination therapy is the most effective treatment.'
NEJM 2010;362-1383-1395
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