Long-term management of resistant, fistulazing Crohn's disease by ongoing 4-weekly infliximab therapy (a case report)

Background: Management of fistulizing Crohn's disease has been revolutionized by anti-TNF biologics. Scheduled ongoing anti-TNF therapy for maintenance, with a recommended frequency of 8 weeks has been established by the ACCENT-I trial and subsequent analyses (eg. Gastroenterology,126:402–413). However, almost two third of patients remain symptomatic. Our Patient: is a 20 year-old male subject with a 3 years' history of fistulizing Crohn's Disease. Because of resistance to standard immunosuppressive medications (steroids & azathioprine (AZA) in addition to 5ASA), he received the first 3 cycles of infliximab in M…