Article (Scientific journals)
Long-term outcome after infliximab for refractory ulcerative colitis
Ferrante, M.; Vermeire, S.; Fidder, H. et al.
2008In Journal of Crohn's and Colitis, 2 (3), p. 219-225
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Keywords :
inflammatory bowel disease; ulcerative colitis; infliximab; anti-tnf; outcome; colectomy; predictor; crohns-disease; medical therapy; predictors
Abstract :
[en] Background and aims: Infliximab (IFX) has been shown efficacious for moderate-to-severe ulcerative colitis (UC), but data on long-term efficacy are tacking. We investigated long-term outcome including colectomy rates in outpatients treated with IFX for refractory UC in a single referral centre, and evaluated if predictors could be identified. Methods: The first 121 outpatients (median age 38.0 years) with refractory UC treated with IFX were included. The primary outcome was colectomy-free survival. Secondary measures were sustained clinical response and serious adverse events. Results: From the 81 patients (67%) with an initial clinical response to IFX, 68% had a sustained clinical response. No independent predictors of sustained clinical response could be identified. Over a median (IQR) follow-up period of 33.0 (17.0-49.8) months, 21 patients (17%) came to colectomy. Independent predictors of colectomy were absence of short-term clinical response [Hazard ratio 10.8 (95% Cl 3.5-32.8), p < 0.001], a baseline CRP level >= 5 mg/L [Hazard ratio 14.5 (95% Cl 2.0-108.6), p=0.006] and previous IV treatment with corticosteroids and/or cyctosporine [Hazard ratio 2.4 (95% Cl 1.1-5.9), p=0.033]. Six patients developed a serious infection, three a malignancy, two a post-operative complication and one patient died (suicide). Conclusions: With a median follow-upof 33.0 months after start of IFX, 17% of patients with refractory UC needed colectomy, while sustained clinical response was present in 68% of initial responders. (c) 2008 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Ferrante, M.
Vermeire, S.
Fidder, H.
Schnitzler, F.
Noman, M.
Van Assche, G.
De Hertogh, G.
Hoffman, I.
D'Hoore, A.
Van Steen, Kristel  ;  Université de Liège - ULiège > Dép. d'électric., électron. et informat. (Inst.Montefiore) > Bioinformatique
Geboes, K.
Penninckx, F.
Rutgeerts, P.
More authors (3 more) Less
Language :
English
Title :
Long-term outcome after infliximab for refractory ulcerative colitis
Publication date :
2008
Journal title :
Journal of Crohn's and Colitis
ISSN :
1873-9946
eISSN :
1876-4479
Publisher :
Elsevier, United Kingdom
Volume :
2
Issue :
3
Pages :
219-225
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 22 May 2010

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