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To the Editor:

I read with interest the article by Yoshida et al published in the current issue of Inflammatory Bowel Diseases.1 These authors studied a total of 31 patients with Crohn's disease (CD) subjected to ileocolic resection and randomly assigned after surgery to infliximab monotherapy or no treatment. They report that at 12 and 36 months the large majority of infliximab-treated patients were in clinical, endoscopic, and serological remission, whereas in the no-treatment arm a much higher proportion of patients had recurrence. However, there were no differences among the two groups when clinical recurrence was based on the Crohn's Disease Activity Index (CDAI) score. The authors conclude that early intervention with infliximab monotherapy is effective and might minimize side effects.

Anti-tumor necrosis factors (TNFs) have been shown to be potentially effective to prevent postoperative recurrence of CD since 2006.2 Virtually all subsequent studies published in final or abstract form have reported a great efficacy of these medications for such complication (reviewed by De Cruz et al3). Two major randomized controlled trials (RCTs) are well underway to confirm these findings on a large scale3 and may hopefully lead to a new clinical indication for these drugs. The conclusions by Yoshida et al are very much in line with what has already been published—however, it is unclear how they reach them.

Issue Section:
Letters to the Editor
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