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Moss AC et al. - The combination of maintenance infliximab and an immunomodulator produced modest improvements in outcomes beyond maintenance infliximab alone in this cohort.


Exclusive Author Commentary
Alan C. Moss, 06/22/09

Our study found that combining azathioprine or 6MP with infliximab (combination therapy) produced differences in remission rates that were significant at 1 year, but not 2 or 5 year end-points. Theses results are similar to post-hoc analyses of the maintenance studies of infliximab, adalimumab and certolizumab; patients on combination therapy had similar remission rates to those on monotherapy with an anti-TNF. These populations, and ours, are different to those enrolled in the recent SONIC study. The patients enrolled in SONIC had a shorter duration of disease, and were all immunomodulator-naive. Thus one can speculate that intervention with combination therapy early in the course of Crohn's disease produces better results than using this approach later on. Whether using combination therapy in this population will result in any higher risk for serious infections or lymphoma is currently unknown.

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