Remicade has not resulted in decreased hospital visits for IBD

Remicade has not yielded expected declines in hospitalisation and intestinal resection rates in IBD

https://www.crohnsforum.com/threads/remicade-anti-tnf-therapy-has-not-yielded-expected-declines-in-hospitalisation-and-intestinal-resection-rates-in-inflammatory-bowel-diseases.85089/

@scifigal - It's very long but the discussion in the thread is fascinating. I'm not sure if I agree with kiny or not, but he is right that Remicade in the beginning was only used as an acute treatment or rescue med, i.e. an infusion as a last resort before surgery. Would be interesting to see the data for those early Remicade users if there's any. I find it hard to believe that just one dose of Remicade would be sufficient for most patients. I have heard of some patients seeing a drastic improvement after one dose, but most patients take more like 2-3 doses, or even longer, to reach remission.

But yeah, kiny's theory about Remicade blocking the innate immune response and triggering the adaptive immune system to keep on attacking does make sense in the context of the article and Remicade stopping working after a time for so many people. There are numerous inflammation pathways in the body; and if one is blocked, the body finds new pathways with which to trigger inflammation and cause you misery.

However, I don't agree with his conclusions that we should just all stop taking Remicade after one dose and suck it up. (I'm sorry: enteral nutrition is not a viable long-term solution. Besides, even he admits it doesn't work very well for colitis.)

What we need is a radical breakthrough in Crohn's treatments. Desperately. It won't be MAP antibiotics or messing about with the gut flora; the only faint glimmer of hope on the horizon seems to be Qu Biologics :-/

Yeah, it is very long. I did blip over bits of it towards the end, but read nearly all of it. Wasn't doing anything else and I found it interesting.

No, to be fair, kiny never suggested staying on enteral nutrition for life. But he did suggest the standard 8 week course wasn't long enough. I'm all for giving it a go, especially in children with small bowel Crohn's - it's safer than steroids. But the problem is, diet - like everything else - doesn't last. Some people get lucky and stay in remission for years (sometimes without being on meds or following a special diet), whilst others can't get into remission at all - it seems so random.