Editing Infliximab (section)

====Inflammatory disease====
Infliximab has been used to induce and maintain remission in inflammatory Crohn's disease. The ACCENT 1 trial, a large, multicentre trial, found 39–45% of patients treated with infliximab, who had an initial response to it, maintained remission after 30 weeks, compared with 21% who received placebo treatment. It also showed a mean maintenance of remission from 38 to 54 weeks compared with 21 weeks for patients who received placebo treatment.<ref name=ACCENT1>{{cite journal | vauthors = Hanauer SB, Feagan BG, Lichtenstein GR, Mayer LF, Schreiber S, Colombel JF, Rachmilewitz D, Wolf DC, Olson A, Bao W, Rutgeerts P | title = Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial | journal = Lancet | volume = 359 | issue = 9317 | pages = 1541–9 | date = May 2002 | pmid = 12047962 | doi = 10.1016/S0140-6736(02)08512-4 | s2cid = 1905194 }}</ref>

Crohn's patients have flares of their disease between periods of disease quiescence. Severe flares are usually treated with [[Prednisone|steroid]] medications to obtain remission, but steroids have many undesirable side effects, so some gastroenterologists are now advocating the use of infliximab as the first drug to try to get patients into [[remission (medicine)|remission]]. This has been called the top-down approach to treatment.<!--
--><ref name=topdown>{{cite journal | vauthors = Hanauer SB | title = Crohn's disease: step up or top down therapy | journal = Best Pract Res Clin Gastroenterol | volume = 17 | issue = 1 | pages = 131–7 | date = February 2003 | pmid = 12617888 | doi = 10.1053/bega.2003.0361 }}</ref>