Article (Scientific journals)
Mucosal Healing Predicts Long-term Outcome of Maintenance Therapy with Infliximab in Crohn's Disease
Schnitzler, F.; Fidder, H.; Ferrante, M. et al.
2009In Inflammatory Bowel Diseases, 15 (9), p. 1295-1301
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Keywords :
crohn's disease; infliximab; mucosal healing; changing disease course; long-term endoscopic outcome; inflammatory-bowel-disease; randomized-trial; azathioprine; evolution; behavior
Abstract :
[en] Background: Infliximab (IFX) treatment induces mucosal healing (MH) in patients with Crohn's disease (CD) but the impact of MH oil the long-term outcome of IFX treatment in CID is still debated. Methods: We studied MH during long-term treatment with IFX in 214 CID patients. A total of 193 patients (85.5%) responded to induction therapy and 31 patients (14.5%) were primary nonresponders. They underwent lower gastrointestinal (GI) endoscopy within a median of 0.7 months (interquartile range [IQR] 0.1-6.9) prior to first IFX and after a median of 6.7 months (IQR 1.4-24.6) after start of IFX and were further analyzed. The relationship between the outcome of IFX treatment long-term and MH was studied. Results: MH was observed in 67.8% of the 183 initial responders (n = 124), with 83 patients having complete healing (45.4%) and 41 having partial healing (22.4%). Scheduled IFX treatment from the start resulted in MH more frequently (76.9% MH rate) than episodic treatment (61.0% MH rate; P = 0.0222, odds ratio [OR] 2.14, 95% confidence interval [CI] 1.11-4.12). Concomitant treatment with corticosteroids (CS) had a negative impact on MH (37.9% in patients with CS versus 63.2% in patients without CS; P = 0.021, OR 0.36, 95% CI 0.16-0.80). MH was associated with a significantly lower need for major abdominal surgery (MAS) during long-term follow-up (14.1% of patients with MH needed MAS versus 38.4% of patients Without MH: P < 0.0001). Conclusions: MH induced by long-term maintenance IFX treatment is associated with an improved long-term outcome of the I disease especially with a lower need for major abdominal surgeries.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Schnitzler, F.
Fidder, H.
Ferrante, M.
Noman, M.
Arijs, I.
Van Assche, G.
Hoffman, I.
Van Steen, Kristel  ;  Université de Liège - ULiège > Dép. d'électric., électron. et informat. (Inst.Montefiore) > Bioinformatique
Vermeire, S.
Rutgeerts, P.
Language :
English
Title :
Mucosal Healing Predicts Long-term Outcome of Maintenance Therapy with Infliximab in Crohn's Disease
Publication date :
2009
Journal title :
Inflammatory Bowel Diseases
ISSN :
1078-0998
eISSN :
1536-4844
Publisher :
Lippincott Williams & Wilkins, Hagerstown, United States - Maryland
Volume :
15
Issue :
9
Pages :
1295-1301
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 23 May 2010

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