Impact of mucosal healing on long‐term outcomes in ulcerative colitis treated with infliximab: a multicenter experience. Issue 10 (21st March 2013)

• Record Type: Journal Article
• Authors: Laharie, D.; Filippi, J.; Roblin, X.; Nancey, S.; Chevaux, J.‐B.; Hébuterne, X.; Flourié, B.; Capdepont, M.; Peyrin‐Biroulet, L.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 37:Issue 10(2013)
• Page Start: 998
• Page End: 1004
• Publication Date: 2013-03-21
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.12289
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" xml:lang="en" id="apt12289-abs-0001"> <title>Summary</title> <sec id="apt12289-sec-0001" sec-type="section"> <title>Background</title> <p>Mucosal healing can be achieved with infliximab (IFX).</p> </sec> <sec id="apt12289-sec-0002" sec-type="section"> <title>Aim</title> <p>To assess the impact of mucosal healing on long‐term outcomes in patients with ulcerative colitis (UC) when treated with infliximab (IFX) beyond 1 year.</p> </sec> <sec id="apt12289-sec-0003" sec-type="section"> <title>Methods</title> <p>All consecutive adult patients with refractory UC receiving maintenance treatment with IFX in five French referral centres were analysed retrospectively. Only patients who had endoscopic evaluation between 6 and 52 weeks following IFX initiation were included. According to their Mayo endoscopic sub‐score, patients were categorised into mucosal healing (sub‐score: 0–1) and no mucosal healing (2–3). Outcome measures were colectomy and IFX failure defined by drug withdrawal due to secondary failure among primary responders.</p> </sec> <sec id="apt12289-sec-0004" sec-type="section"> <title>Results</title> <p>Of the 63 patients (30 women; median age: 38 years), 30 (48%) achieved mucosal healing. The median follow‐up duration was 27 (3–79) months. Colectomy‐free survival rates at 12, 24 and 36 months were, respectively, 100%, 96% and 96% in patients with mucosal healing. The corresponding figures were, respectively, 80%, 65% and 65% in patients without mucosal healing (<italic>P</italic> = 0.004). By multivariate analysis, mucosal healing was the only factor associated with colectomy‐free survival, with an odds ratio of 18.01 (95%CI: 1.58–204.92). IFX failure‐free survival rates at 12, 24 and 36 months were, respectively, 76%, 69% and 64% in patients with mucosal healing, and 44%, 25% and 21% in those without mucosal healing (<italic>P</italic> = 0.003).</p> </sec> <sec id="apt12289-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Patients with refractory UC who achieved mucosal healing after IFX initiation had better long‐term outcomes, with significantly less colectomy and less IFX failure.</p> </sec> </abstract>