W1288 Long-Term Scheduled Therapy With Infliximab in Inflammatory Bowel Disease: A Single-Centre Observational Study

  • Armuzzi A
  • Marzo M
  • Felice C
  • et al.
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Abstract

Background & Aim: Limited data have been reported about Infliximab (IFX) scheduled therapy beyond 1 year and follow-up (FU) after discontinuation in Crohn's disease (CD) and ulcerative colitis (UC). Aims: 1) to analyze the effectiveness of long-term IFX therapy in inflammatory bowel disease (IBD); 2) to identify predictors for sustained clinical benefit during IFX treatment and after discontinuation. Materials & Methods: Medical records of patients treated with IFX scheduled therapy for more than 1 year at our Unit were reviewed and details on demographic, clinical, laboratory and endoscopic characteristics and adverse events (AE) recorded. Results: 174 patients (109 CD, 65 UC) were identified. 3021 infusions were administered over 26-month (range: 15-91) median treatment, with a median of 15 infusions/patient (9-49) and with 42-month (18-101) median FU since first IFX infusion. CD patients: 60% (n=65) discontinued IFX for: stable remission (43), AE (9), loss of response (14); 40% (44) are in clinical benefit on scheduled IFX. Mucosal healing (MH) was observed in 55% at last observation while on IFX. Cox regression identified MH (P=.006) as predictor of sustained clinical benefit during IFX therapy. After 13-month (4-74) median FU since IFX discontinuation for stable remission, 51% maintain remission. Cox regression identified MH (P=.002) and low C-reactive protein (CRP) at discontinuation (P=.03) as predictors of sustained remission after IFX withdrawal. UC patients: 48% (n=31) discontinued IFX for: stable remission (22), AE (4), loss of response (7); 52% (34) are in clinical benefit on scheduled IFX. MH was observed in 56% at last observation while on IFX. Cox regression identified low CRP after induction (P=.01) as predictor of sustained clinical benefit during IFX therapy. After 16-month (4-30) median FU since IFX discontinuation for stable remission, 59% maintain remission. Cox regression identified MH (P=.03) and low CRP at discontinuation (P=.007) as predictors of sustained remission after IFX withdrawal. IBD patients: 85% discontinued steroids. AE occurred in 14%, causing IFX discontinuation in 7.5%. MH was associated with significant decrease in the need of abdominal surgery for CD (P=.01) and colectomy for UC (P=.04) during long-term FU. Conclusion: Long-term IFX treatment is effective and safe to maintain clinical benefit in our IBD cohort. Sustained clinical remission was observed in more than half of patients after IFX discontinuation. MH was associated with lower need of abdominal surgery. MH and CRP could help to identify IBD patients maintaining clinical benefit during IFX therapy and sustained remission after IFX discontinuation.

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Armuzzi, A., Marzo, M., Felice, C., De Vincentis, F., Andrisani, G., Mocci, G., … Guidi, L. (2010). W1288 Long-Term Scheduled Therapy With Infliximab in Inflammatory Bowel Disease: A Single-Centre Observational Study. Gastroenterology, 138(5), S-691-S-692. https://doi.org/10.1016/s0016-5085(10)63179-4

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