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Long-term outcome after infliximab for refractory ulcerative colitis.
MedLine Citation:
PMID:  21172214     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND AND AIMS: Infliximab (IFX) has been shown efficacious for moderate-to-severe ulcerative colitis (UC), but data on long-term efficacy are lacking. 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% CI 3.5-32.8), p<0.001], a baseline CRP level ≥5 mg/L [Hazard ratio 14.5 (95% CI 2.0-108.6), p=0.006] and previous IV treatment with corticosteroids and/or cyclosporine [Hazard ratio 2.4 (95% CI 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-up of 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.
Marc Ferrante; Séverine Vermeire; Herma Fidder; Fabian Schnitzler; Maja Noman; Gert Van Assche; Gert De Hertogh; Ilse Hoffman; Andre D'Hoore; Kristel Van Steen; Karel Geboes; Freddy Penninckx; Paul Rutgeerts
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Publication Detail:
Type:  Journal Article     Date:  2008-05-16
Journal Detail:
Title:  Journal of Crohn's & colitis     Volume:  2     ISSN:  1873-9946     ISO Abbreviation:  J Crohns Colitis     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2010-12-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101318676     Medline TA:  J Crohns Colitis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  219-25     Citation Subset:  -    
Department of Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
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