Long-term outcome of treatment with infliximab in 614 patients with Crohn's disease: results from a single-centre cohort. Issue 4 (2nd October 2008)

• Record Type: Journal Article
• Authors: Schnitzler, F; Fidder, H; Ferrante, M; Noman, M; Arijs, I; Van Assche, G; Hoffman, I; Van Steen, K; Vermeire, S; Rutgeerts, P
• Is Part Of: Gut. Volume 58:Issue 4(2009)
• Page Start: 492
• Page End: 500
• Publication Date: 2008-10-02
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.2008.155812
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background and aims: This observational study assessed the long-term clinical benefit of infliximab (IFX) in 614 consecutive patients with Crohn's disease (CD) from a single centre during a median follow-up of 55 months (interquartile range (IQR) 27–83). Methods: The primary analysis looked at the proportion of patients with initial response to IFX who had sustained clinical benefit at the end of follow-up. The long-term effects of IFX on the course of CD as reflected by the rate of surgery and hospitalisations and need for corticosteroids were also analysed. Results: 10.9% of patients were primary non-responders to IFX. Sustained benefit was observed in 347 of the 547 patients (63.4%) receiving long-term treatment. In 68.3% of these, treatment with IFX was ongoing and in 31.7% IFX was stopped, with the patient being in remission. Seventy patients (12.8%) had to stop IFX due to side effects and 118 (21.6%) due to loss of response. Although the yearly drop-out rates of IFX in patients with episodic (10.7%) and scheduled treatment (7.1%) were similar, the need for hospitalisations and surgery decreased less in the episodic than in the scheduled group. Steroid discontinuation also occurred in a higher proportion of patients in the scheduled group than in the episodic group. Conclusions: In this large real-life cohort of patients with CD, long-term treatment with IFX was very efficacious to maintain improvement during a median follow-up of almost 5 years and changed disease outcome by decreasing the rate of hospitalisations and surgery.