Evaluation of the Clinical and Immunological Impact of Two Therapeutic Strategies in Chronic Inflammatory Diseases

Evaluation of the Clinical and Immunological Impact of Two Therapeutic Strategies (Increasing the Infliximab Dose or Introduction of Immunosuppressive Therapy) in Patients Chronic Inflammatory Bowel Diseases in Loss of Response to Infliximab

This study evaluates 2 therapeutic strategies (increase infliximab dose or add an immunosuppressant) in patients with inflammatory bowel disease in loss of response to infliximab. Addition of an immunosuppressant may be more efficient at long term and is less expensive.

Inclusion Criteria:

• patients with ulcerative colitis or crohn's disease
• treated with infliximab (5mg/kg per 8 weeks) and with loss of response after at least 4 infusions of infliximab
• active disease ( HBI > 5 for CD patients or SCCAI> 6 for UC patients)
• patients treated with infliximab only at the time of loss of response

Exclusion Criteria:

• Patients with CD with ano perineal lesions and without luminal activity
• patients treated with cortico steroids and having had history of intolerance to azathioprin, 6-mercaptopurine or methotrexate
• patients with acute severe flare (HBI>12 for CD patients and Lichtiger score > 10 for UC patients)
• pregnant female
• patients with anal disease alone