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Crohn’s disease, fatigue, and infliximab: Is there a role for cytokines in the pathogenesis of fatigue?

2007; Baishideng Publishing Group; Volume: 13; Issue: 14 Linguagem: Inglês

10.3748/wjg.v13.i14.2089

2219-2840

Itta M. Minderhoud,

Microscopic Colitis

AIM:To study the effect of infliximab on fatigue in relation to cytokine levels in Crohn's disease (CD) patients. METHODS:Fourteen CD patients were blinded for treatment and received placebo at baseline, and infliximab 2 wk later, with a follow-up of 4 wk.Blood samples were drawn on a regular basis, and questionnaires on fatigue, depression, quality of life, and clinical disease activity were completed at regular intervals. RESULTS:After placebo infusion, fatigue scores decreased within 3 d (3.5 points ± 1.1, P ≤ 0.01), but returned to baseline values 14 d after this infusion.The drop of fatigue scores following infliximab infusion sustained until the end of the study (3.8 points ± 1.4, P ≤ 0.05).Quality of life was increased at the end of the study compared to baseline values (138.6 ± 9.4 vs 179.4 ± 6.7; P ≤ 0.005), whereas depression scores were decreased (20.4 ± 9.4 vs 11.3 ± 2.2; P ≤ 0.01).No correlation between the severity of fatigue and the level of cytokines was observed. CONCLUSION:The reduction of fatigue after infliximab infusion is subjective to a placebo effect.The effect of infliximab on fatigue, however, persists while the placebo effect disappears after a short period of time.A clear role of cytokines could not be substantiated.