Remicade Failure in Crohn's Disease

Patients who suffer from moderate to severe Crohn's disease and have not responded well to other treatments may be put on Remicade. Remicade is designed to reduce the signs and symptoms of Crohn's disease and help introduce or maintain remission. Not all patients respond to Remicade similarly and there are a few characteristics that may help determine Remicade's potential success or failure.

Smoking

• Smoking

  One of the most apparent predictors of Remicade failure in treating Crohn's disease is smoking. In a study of 100 Crohn's disease patients on Remicade in the United States, nonsmokers had a higher response rate to Remicade than smokers. Additionally, smokers were more likely to relapse and have Remicade fail within one year of beginning Remicade therapy.

Age

• Old age

  The second factor that may predict the effectiveness of Remicade in Crohn's disease patients is age. In clinical studies, it appears that younger adult patients respond better to Remicade than older patients. Doctors are unclear why older age is a factor in Remicade failure but believe that older patients have a decreased immune system and therefore are unable to respond to Remicade like younger patients.

Surgery

• Surgery

  Patients who have already undergone surgery to treat their Crohn's disease or other digestive tract surgery are less likely to respond to Remicade. Doctors also believe that patients who have intestinal strictures experience a higher rate of Remicade failure compared to patients who do not have intestinal strictures.

Infections

• Remicade can lower the effectiveness of a patient's immune system, allowing for the potential of serious infections. Infections include tuberculosis, viruses, fungi and bacteria. These infections can be fatal. Remicade should not be used in patients who have an infection, cancer, heart condition or liver problem.

Additional Characteristics

• In clinical studies, doctors feel there is a correlation between genetics, immune system and environmental factors when determining the successes or failure of Remicade in treating patients with Crohn's disease. Additional studies are being conducted to further expand upon this hypothesis.