Reference : Mucosal Healing Predicts Long-term Outcome of Maintenance Therapy with Infliximab in ...
Scientific journals : Article
Human health sciences : Gastroenterology & hepatology
http://hdl.handle.net/2268/38576
Mucosal Healing Predicts Long-term Outcome of Maintenance Therapy with Infliximab in Crohn's Disease
English
Schnitzler, F. [ > > ]
Fidder, H. [> > > >]
Ferrante, M. [ > > ]
Noman, M. [> > > >]
Arijs, I. [> > > >]
Van Assche, G. [> > > >]
Hoffman, I. [> > > >]
Van Steen, Kristel mailto [Université de Liège - ULg > Dép. d'électric., électron. et informat. (Inst.Montefiore) > Bioinformatique >]
Vermeire, S. [> > > >]
Rutgeerts, P. [> > > >]
2009
Inflammatory Bowel Diseases
Lippincott Williams & Wilkins
15
9
1295-1301
Yes (verified by ORBi)
International
1078-0998
1536-4844
Hagerstown
MD
[en] crohn's disease ; infliximab ; mucosal healing ; changing disease course ; long-term endoscopic outcome ; inflammatory-bowel-disease ; randomized-trial ; azathioprine ; evolution ; behavior
[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.
http://hdl.handle.net/2268/38576

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