Infliximab has been found to be effective in some cases of Crohn’s disease for many years but its use in ulcerative colitis is more recent. A significant number of patients with both conditions fail to respond to treatment. One of the reasons for this may be explained by a recent study from the Netherlands providing an interesting insight into why some patients with Ulcerative Colitis (UC) do not respond to infliximab. It is because infliximab is excreted in the faeces. 30 patients were studied during the first two weeks of infliximab therapy and the drug was detected in 129 of 195 faecal samples. Patients who were no better after two weeks treatment were found to have had higher amounts of infliximab in the stool on the first day of treatment.
The reason for the high loss of the drug is not fully understood but may be associated with the presence of large ulcers on the colonic lining in UC as this may allow more to leak out from the bloodstream.
(Ref: Brandse et al Gastroenterology 2015 149 350-355)
This article was first published on the original crohns.org.uk blog. Research has moved on since, so please check current advice with your IBD team.