Long-term efficacy of infliximab for refractory ulcerative colitis: results from a single center experience

• Published in: BMC gastroenterology Vol. 14; no. 1; p. 80
• Main Authors: Yamada, Satoshi, Yoshino, Takuya, Matsuura, Minoru, Minami, Naoki, Toyonaga, Takahiko, Honzawa, Yusuke, Tsuji, Yoshihisa, Nakase, Hiroshi
• Format: Journal Article
• Language: English
• Published: England BioMed Central 23.04.2014; BioMed Central Ltd
• Subjects: Adolescent; Adult; Aged; Antibodies, Monoclonal - therapeutic use; C-Reactive Protein - immunology; Clinical outcomes; Cohort Studies; Colitis, Ulcerative - drug therapy; Colitis, Ulcerative - immunology; Crohns disease; Cytomegalovirus; Deoxyribonucleic acid; DNA; Drug dosages; Drug therapy; Female; Gastroenterology; Gastrointestinal Agents - therapeutic use; Hepatology; Hospitalization; Humans; Infections; Inflammatory bowel disease; Infliximab; Longitudinal Studies; Male; Middle Aged; Multivariate Analysis; Regression Analysis; Remission Induction; Retrospective Studies; Severity of Illness Index; Studies; Treatment Outcome; Young Adult
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/1471-230x-14-80

The long-term efficacy of infliximab (IFX) for patients with refractory ulcerative colitis (UC) is unclear. The aim of this study was to assess the long-term outcomes of IFX treatment in patients with refractory UC. Thirty-three patients with refractory UC who received IFX treatment at Kyoto University Hospital between 2003 and 2013 were retrospectively evaluated. IFX intensification was defined as a dose escalation (up to 10 mg/kg) and/or shorter intervals between infusions (every 4-6 weeks). Of the 33 patients who received scheduled infusions of IFX, 24 (72.7%) achieved clinical remission within 8 weeks after initiating IFX treatment. Of these 24 responders, 17 (70.8%) experienced a relapse of UC and required IFX intensification, and 16 (66.7%) eventually maintained clinical remission with IFX treatment, including IFX intensification. Of the 33 patients, 6 (18.2%) underwent colectomy during IFX treatment. Multivariate regression analysis showed that a serum C-reactive protein (CRP) concentration <5 mg/L two weeks after starting IFX was a predictor of a positive clinical response to IFX induction therapy. No severe adverse events occurred in UC patients treated with IFX. IFX intensification was necessary for long-term maintenance of remission and to prevent colectomy in patients with refractory UC.