In the present prospective pilot study, infliximab was administered 2 weeks after surgery, along with low-dose methotrexate, whereas controls were treated with mesalamine alone. There is no evidence for a role of methotrexate in preventing recurrence5; however, we elected to use this drug because it is known to reduce long-term immunogenicity of infliximab.6 This is not a randomized study: the decision to include a patient in one group or the other, given the experimental nature of the infliximab-based preventive strategy, was solely based on the full understanding and approval (with written informed consent) of each patient. Before surgery, patients to be treated with infliximab were screened (purified protein derivative skin test, chest radiography, and careful history taking) and were found negative for latent tuberculosis. They were also evaluated (and found negative) for past and present cardiac, neurologic, lymphoproliferative, and other neoplastic diseases. After surgery, patients were subjected to endoscopy at 12 and 24 months; small-bowel enteroclysis or magnetic resonance imaging at 12 and 24 months; and physical examination with interviews, together with an extensive battery of blood tests (complete blood cell count; erythrocyte sedimentation rate; C-reactive protein, albumin, electrolyte, autoantibody, and thyroid hormone levels; and liver and renal function tests) every 3 months. Infliximab was given as a slow intravenous infusion at the dosage of 5 mg/1 kg of body weight, with an intravenous 100-mg bolus hydrocortisone starting from 2 weeks after surgery, followed by standard maintenance treatment (2, 6, and then every 8 weeks) and therapy with low-dose methotrexate (10 mg/wk by mouth).