Long-term outcome after infliximab for refractory ulcerative colitis
Marc Ferrante1, Séverine Vermeire, Herma Fidder
1Department of Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
Journal of Crohn'S & Colitis
|December 22, 2010
Summary
Long-term infliximab (IFX) treatment for ulcerative colitis (UC) showed sustained clinical response in 68% of patients. However, 17% of patients with refractory UC required colectomy within 33 months.
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Infliximab (IFX) is effective for moderate-to-severe ulcerative colitis (UC).
- Long-term efficacy and colectomy rates for IFX in refractory UC are not well-established.
- Predictors for long-term outcomes in IFX-treated UC patients require investigation.
Purpose of the Study:
- To evaluate the long-term outcomes of IFX treatment in refractory UC patients.
- To determine colectomy rates and sustained clinical response.
- To identify predictors of colectomy and sustained response.
Main Methods:
- A cohort of 121 outpatients with refractory UC treated with IFX was analyzed.
- Primary outcome: colectomy-free survival.
- Secondary outcomes: sustained clinical response and serious adverse events.
Main Results:
- Sustained clinical response was observed in 68% of initial responders.
- Over a median follow-up of 33 months, 17% of patients underwent colectomy.
- Predictors for colectomy included absence of short-term response, baseline CRP ≥5 mg/L, and prior IV corticosteroid/cyclosporine treatment.
Conclusions:
- Long-term IFX treatment for refractory UC leads to colectomy in 17% of patients.
- Sustained clinical response is achieved in a majority of initial responders.
- Predictive factors for colectomy can guide treatment decisions.
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