Remicade is indicated for reducing signs and symptoms, and inducing and maintaining clinical remission in adult and pediatric patients with moderately to severely active Crohn's disease who have had an inadequate response to conventional therapy, according to the product label. Remicade contains infliximab, a monoclonal antibody that reduces inflammation and slows down structural damage in the intestines associated with Crohn's disease. Remicade can be used concomitantly with antibiotics, corticosteroids, methotrexate, azathioprine and aminosalicylates to treat Crohn's disease.
Antibiotics
Antibiotics such as metronidazole, ampicillin and ciprofloxacin are used to treat Crohn's disease, according to Crohn's and Colitis Foundation of America. Antibiotics can help to reduce inflammation and harmful intestinal bacteria, but symptoms recur once treatment is discontinued. According to 2009 information from MayoClinic.com, metronidazole was once the most commonly used antibiotic for Crohn's disease, and now ciprofloxacin is the generally preferred antibiotic. Research conducted by R.L. West and published in "Alimentary Pharmacology and Therapeutics" in 2004, demonstrated that a combination of ciprofloxacin and infliximab is more effective in treating Crohn's disease than infliximab alone.
Corticosteroids
Corticosteroids, such as prednisone and methylprednisolone, are used orally and rectally to treat Crohn's disease, according to the Crohn's and Colitis Foundation of America. Corticosteroids are usually prescribed for short-term use, about 3 to 4 months, to help reduce inflammation in the intestines. However, these drugs have significant short and long-term side effects that include immune suppression, yeast infection and weight gain.
Methotrexate
Methotrexate is a fast-acting immunosuppressant that is given weekly to treat patients with severe Crohn's disease who have not been helped by other immunosuppressant drugs, according to the University of Maryland Medical Center. However, methotrexate can have serious side effects that include miscarriages, birth defects, liver damage and inflammation of the pancreas. Research conducted by O. Schroder and published in "European Journal of Gastroenterology and Hepatology" in 2006, observed that 71 percent of patients with Crohn's disease treated with infliximab concomitantly with methotrexate had clinical remission.
Azothioprine
Azathioprine is an immune modulator that is used to decrease corticosteroid dosage, heal structural damage caused by Crohn's disease and maintain disease remission, according to the Crohn's and Colitis Foundation of America. Research conducted by J.F. Colombel and published in the "New England Journal of Medicine" in 2010, discovered that patients with moderate-to-severe Crohn's disease who were treated with infliximab plus azathioprine or infliximab alone were more likely to have corticosteroid-free clinical remission than patients receiving azathioprine alone.
Aminosalicylates
Aminosalicylates, such as sulfasalazine and mesalamine, can be used to treat mild to moderate symptoms of Crohn's disease, according to the Crohn's and Colitis Foundation of America. The University of Maryland Medical Center states that aminiosalicylates can maintain remission and prevent relapses in patients with Crohn's disease, but some people are allergic to sulfa drugs, such as sulfasalazine, and mesalamine can cause kidney problems.
References
- Centocor Ortho Biotech: Remicade Prescribing Information
- "Alimentary Pharmacology and Therapeutics"; Clinical Effect of Ciprofloxacin on Treatment of Crohn's Disease with Infliximab; West, R.L.; Dec 2004
- University of Maryland Medical Center: Crohn's Disease - Medications
- "European Journal of Gastroenterology and Hepatology"; Combining Infliximab with Methotrexate for Crohn's Disease; Schroder, O.; Jan 2006
- "New England Journal of Medicine"; Infliximab, Azathioprine, or Combination Therapy for Crohn's Disease; Colombel, J.F.; Apr 15 2010
