Infliximab Maintenance Therapy Is Associated With Decreases in Direct Resource Use in Patients With Luminal or Fistulizing Crohn's Disease

Goals: To estimate the impact of infliximab (IFX) maintenance therapy on the use of hospital resources in patients with Crohn's disease (CD). Study: Medical records of Patients treated with IFX maintenance luminal therapy (5 mg/kg body weights intravenous infusion) for (L) or fistulizing (F) CD at 13 hospitals were retrospectively reviewed. Patients were assessed as their own controls. Use of CD-related healthcare resource,, was recorded comparing 1-year periods before and after first IFX infusion (pre-IFX and post-IFX). Results: One hundred fifty-three CD patients (n = 84 L; 69 F) fulfilled the inclusion criteria. Mean number of IFX infusions Was 7/y with an average of 335 mg/infusion dose/patient. During the pre-IFX period, 55% of patients needed hospitalization versus 31% in the post-IFX period (P < 0.001). Mean inpatient stay was 11.3 d/y [11.2 (L) 11.5 (F)] for the pre-IFX period, and 6.3 d/y [6.2 (L) 6.3 (F)] in the post-IFX period (P<0.001). Surgery was required in 24% patients in the pre-IFX period and in 11% post-IFX (P < 0.001). There were no significant changes in the incidence of outpatient visits although emergency room visits fell significantly. Conclusions: Maintenance IFX in CD patients is associated with decreases in the use and length of hospitalizations and the need for surgery in clinical practice.