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Infliximab for refractory ulcerative colitis or indeterminate colitis: an open-label multicentre study.
J-M Gornet1, S Couve, Z Hassani
1Department of Gastroenterology, Hôpital Saint-Louis, Paris, France. jean-marc.gornet@sls.ap-hop-paris.fr
Alimentary Pharmacology & Therapeutics
|July 19, 2003
Summary
Infliximab shows rapid response in ulcerative colitis (UC) and indeterminate colitis but long-term outcomes are less favorable, with frequent relapses and colectomy rates around one-third.
Area of Science:
- Gastroenterology
- Immunology
Background:
- Efficacy of infliximab in ulcerative colitis (UC) and indeterminate colitis is not well-established.
- Preliminary data on infliximab for UC and indeterminate colitis are conflicting.
Purpose of the Study:
- To assess the efficacy and long-term outcomes of infliximab in patients with UC or indeterminate colitis.
- To evaluate response rates, remission, colectomy rates, and factors influencing outcomes.
Main Methods:
- Retrospective review of 30 patients with UC (n=19) or indeterminate colitis (n=11) treated with infliximab.
- Patients had steroid-refractory, -dependent, or -intolerant disease, or had failed cyclosporine; 19 had severe flare-ups.
Main Results:
- 75% initial response at day 7, 50% at month 1; 43% complete remission at day 7, 32% at month 1.
- Relapse probability was 73% at 6 months; 57% achieved steroid-free remission at 6 months.
- Colectomy probability was 33% at 12 months; lower response rates in indeterminate colitis; antimetabolites improved outcomes.
Conclusions:
- Infliximab induces rapid response in refractory UC and indeterminate colitis.
- Long-term outcomes are less favorable, with high relapse rates and significant colectomy requirement.
- Concomitant antimetabolite use may improve infliximab efficacy in these conditions.