A Combo a Day Keeps Surgery Away

Inflammatory bowel disease surgery rates lower with a combination of Remicade and an immunomodulator

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) The body’s immune system is a line of defense against infection. But sometimes, the immune system acts up and attacks the body’s cells.

Inflammatory bowel disease is one such disease in which the immune system attacks the lining of the gut, causing it to swell up and develop sores. Some people even need surgery to treat the disease.

According to a new study, a combination of two medications that temper the immune system can be effective in reducing hospitalization and surgery rates among inflammatory bowel disease patients.

"Ask your doctor about treatments for inflammatory bowel disease."

This study was conducted by Neena Abraham, MD, MSCE, AGAF, of the Division of Gastroenterology and Hepatology at Baylor College of Medicine in Houston, Texas, along with colleagues.

The aim of this study was to find out whether treatment with a combination of infliximab (brand name Remicade) and an immunomodulator reduced rates of hospitalization and surgery in inflammatory bowel disease patients.

The two major kinds of inflammatory bowel disease are ulcerative colitis and Crohn’s disease. Patients with inflammatory bowel disease may have abdominal pain, diarrhea and sometimes more severe symptoms such as blood in stools and weight loss.

Infliximab is a medication used to treat autoimmune diseases, or diseases in which the body’s immune system attacks the body’s own cells.

Immunomodulators such as azathioprine (brand name Imuran) and cyclosporine (brand names Gengraf, Neoral and Sandimmune) act on the immune system to reduce inflammation.

For this study, the researchers looked at data from the Department of Veterans Affairs. They examined records of patients with Crohn’s disease or ulcerative colitis.

The researchers looked at data from three groups of patients — those who were treated with infliximab, those treated with immunomodulators and those treated with a combination of both — to check hospitalization and surgery rates within one year of starting therapy. These rates were compared with the surgery and hospitalization rates of patients who received neither of these medications.

Upon analysis of the data, the researchers found that patients who received a combination of both medications for nine months had a 73.1 percent reduction in hospitalization rates and 92 percent reduction in surgery, as compared to those who did not take these medications.

Infliximab and immunomodulators both reduced the rate of hospitalization and surgery, but dual therapy did so within a shorter duration of treatment.

Overall, the researchers concluded that treatment with dual therapy with infliximab and immunomodulators is beneficial for inflammatory bowel disease patients.

This study was published in the August issue of Clinical Gastroenterology and Hepatology.

The study received funding from Janssen Biotech, Inc, the maker of Remicade. No other potential conflicts of interest were reported.

Review Date: 
August 4, 2013
Last Updated:
August 7, 2013