P507 Efficacy of Infliximab after failure of subcutaneous anti-TNF agents in patients with moderate-to-severe ulcerative colitis. (25th January 2019)

• Record Type: Journal Article
• Authors: Viazis, N; Tsoukali, E; Galanopoulos, M; Pontas, C; Karampekos, G; Filippidis, G; Giouleme, O; Theocharis, G; Tzouvala, M; Archavlis, E; Christidou, A; Mantzaris, G J
• Is Part Of: Journal of Crohn's and colitis. Volume 13(2019)Supplement 1
• Page Start: S366
• Page End: S367
• Publication Date: 2019-01-25
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjy222.631
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: To assess the efficacy of intravenously administered infliximab in patients with moderate to severe ulcerative colitis (UC) who have failed therapy with subcutaneously administered adalimumab or golimumab. Methods: Retrospective analysis of prospectively collected data of all anti-TNF naive UC patients who received adalimumab or golimumab for the treatment of moderate to severe UC in the participating tertiary referral centres. Patients who showed primary non-response or secondary loss of response to the subcutaneously administered anti-TNF were scheduled to receive intravenously administered anti-TNF (infliximab). Primary non-response was defined as failure to achieve a clear improvement in symptoms and a drop in CRP, if elevated at baseline, at Week 6 through Week 14. Secondary loss of response was defined as reappearance of symptoms and re-elevation of CRP at any time period after the first 14 weeks of anti-TNF therapy. Clinical response to infliximab was subsequently assessed at Week 14 and was defined as a decrease in the total Mayo score of at least 3 points and at least 30% per cent from baseline. Finally, clinical remission, defined as Mayo score of ≤ 2 with no individual sub-score > 1, was assessed at Week 54. Results: From September 2015 till September 2017, 58 anti-TNF naive ulcerative colitis patients (males=31, females = 27; E1=1, E2=32, E3=25, median age=40.6 years, median disease duration=38.6 months) were started on adalimumab ( n = 38) or golimumab ( n = 20) because of moderate–severe disease. From these patients, 21 (36.2%) were primary non responders (adalimumab = 13, golimumab = 8), while 8 more (13.7%) showed secondary loss of response (adalimumab = 7, golimumab =1). Therefore, 29 patients were started on infliximab, because of failure of subcutaneously administered anti-TNF. At Week 14, 18 patients showed clinical response (62.1%), while at Week 54, 14 patients were on clinical remission (48.3%). Conclusions: UC patients with moderate to severe disease that are anti-TNF naive can be successfully treated with intravenously administered anti-TNF after failure of anti-TNF administered subcutaneously.