Reference : Maintenance of Remission Among Patients With Crohn's Disease on Antimetabolite Therap...
Scientific journals : Article
Human health sciences : Gastroenterology & hepatology
http://hdl.handle.net/2268/108262
Maintenance of Remission Among Patients With Crohn's Disease on Antimetabolite Therapy After Infliximab Therapy Is Stopped.
English
Louis, Edouard mailto [Centre Hospitalier Universitaire de Liège - CHU > > Gastro-Entérologie-Hépatologie >]
Mary, J. Y. [> > > >]
Vernier-Massouille, G. [> > > >]
Grimaud, J. C. [> > > >]
Bouhnik, Y. [> > > >]
Laharie, D. [> > > >]
Dupas, J. L. [> > > >]
Pillant, H. [> > > >]
Picon, L. [> > > >]
Veyrac, M. [> > > >]
Flamant, M. [> > > >]
Savoye, G. [> > > >]
Jian, R. [> > > >]
DEVOS, Martine [Centre Hospitalier Universitaire de Liège - CHU > > Centre d'oncologie]
Porcher, R. [> > > >]
Paintaud, G. [> > > >]
Piver, E. [> > > >]
Colombel, J. F. [> > > >]
Lemann, M. [> > > >]
2012
Gastroenterology
W.B. Saunders
142
1
63-70.e5; quiz e31
Yes (verified by ORBi)
International
0016-5085
1528-0012
Philadelphia
PA
[en] BACKGROUND & AIMS: It is important to determine whether infliximab therapy can be safely interrupted in patients with Crohn's disease who have undergone a period of prolonged remission. We assessed the risk of relapse after infliximab therapy was discontinued in patients on combined maintenance therapy with antimetabolites and identified factors associated with relapse. METHODS: We performed a prospective study of 115 patients with Crohn's disease who were treated for at least 1 year with scheduled infliximab and an antimetabolite and had been in corticosteroid-free remission for at least 6 months. Infliximab was stopped, and patients were followed up for at least 1 year. We associated demographic, clinical, and biologic factors with time to relapse using a Cox model. RESULTS: After a median follow-up period of 28 months, 52 of the 115 patients experienced a relapse; the 1-year relapse rate was 43.9% +/- 5.0%. Based on multivariable analysis, risk factors for relapse included male sex, the absence of surgical resection, leukocyte counts >6.0 x 10(9)/L, and levels of hemoglobin </=145 g/L, C-reactive protein >/=5.0 mg/L, and fecal calprotectin >/=300 mug/g. Patients with no more than 2 of these risk factors (approximately 29% of the study population) had a 15% risk of relapse within 1 year. Re-treatment with infliximab was effective and well tolerated in 88% of patients who experienced a relapse. CONCLUSIONS: Approximately 50% of patients with Crohn's disease who were treated for at least 1 year with infliximab and an antimetabolite agent experienced a relapse within 1 year after discontinuation of infliximab. However, patients with a low risk of relapse can be identified using a combination of clinical and biologic markers.
http://hdl.handle.net/2268/108262
10.1053/j.gastro.2011.09.034
Copyright (c) 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

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