Long-term outcome of infliximab treatment in chronic active ulcerative colitis: a Swedish multicentre study of 250 patients

Research output: Contribution to journalArticle

Abstract

Background: Real-life long-term data on infliximab treatment in ulcerative colitis are limited. Aim: To study the long-term efficacy and safety of infliximab in chronic active ulcerative colitis and possible predictors of colectomy and response were also examined. Methods: A retrospective multi-centre study of infliximab treatment in 250 patients with chronic active ulcerative colitis with inclusion criteria: age ≥18 years, ambulatory treated, steroid-dependent or intolerant and/or immunomodulator refractory or intolerant. Results: Steroid-free clinical remission was achieved by 123/250 patients (49.2%) at 12 months and in 126/250 patients at a median follow-up of 2.9 years (50.4%). Primary response at 3 months was achieved by 190/250 (76.0%) patients and associated with a high probability of response 168/190 (88.4%) at 12 months and 143/190 (75.3%) at follow-up. Long-term rate of colectomy in primary responders was 6/190 (3.2%) at 12 months and 27/190 (14.2%) at last follow-up. Failure to achieve response at 3 months was associated with a high risk of subsequent colectomy, 29/60 (48.3%) at 12 months and 41/60 (68.3%) at follow-up. Response at 12 months was associated with a low risk of subsequent colectomy, 14/181 (7.7%) compared with non-response 19/34 (55.9%) (P < 0.0001). Non-response at 3 months was an independent predictor of subsequent colectomy (HR = 9.40, 95% CI = 5.10–17.35, P < 0.001). Concomitant azathioprine therapy did not influence outcome in terms of colectomy. Conclusions: Long-term efficacy of infliximab treatment in chronic active ulcerative colitis is excellent especially in patients who respond to induction treatment. Conversely, non-response at 3 months predicts a poor outcome, with a high risk of subsequent colectomy.

Details

Authors
  • Leif Angelison
  • S. Almer
  • A. Eriksson
  • P. Karling
  • U. Fagerberg
  • J. Halfvarson
  • M. Thörn
  • J. Björk
  • U. Hindorf
  • R. Löfberg
  • A. Bajor
  • H. Hjortswang
  • P. Hammarlund
  • O. Grip
  • J. Torp
  • J. Marsal
  • E. Hertervig
Organisations
External organisations
  • Helsingborg Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Pharmacology and Toxicology
Original languageEnglish
Pages (from-to)519-532
Number of pages14
JournalAlimentary Pharmacology and Therapeutics
Volume45
Issue number4
Publication statusPublished - 2017 Feb 1
Publication categoryResearch
Peer-reviewedYes

Related research output

Angelison, L., Marsal, J. & Hertervig, E., 2017 Apr 1, In : Alimentary Pharmacology and Therapeutics. 45, 8, p. 1177-1178 2 p.

Research output: Contribution to journalLetter

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