Infliximab with low-dose methotrexate for prevention of postsurgical recurrence of ileocolonic Crohn disease.

P ostsurgical recurrence of Crohn disease is a very frequent event, and none of the drugs used for the purpose has really shown a clear-cut efficacy. Infliximab, a monoclonal antibody anti–tumor necrosis factor (anti–TNF), is very effective in the treatment of active Crohn disease, but its benefit in preventing postoperative recurrence is still unknown. Yet, its impact, both medical and economic, could be major. Local injection of infliximab for early mucosal postoperative recurrence of Crohn disease seems feasible and safe; however, preliminary results have been disappointing. By contrast, a patient treated with intravenous infliximab immediately after surgery to prevent the recurrence of colonic Crohn disease has been disease free for 48 months after surgery.