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Long-term outcome of infliximab treatment in chronic active ulcerative colitis: a Swedish multicentre study of 250 patients
Helsingborg Hospital, Sweden.
Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
Sahlgrenska University Hospital Östra, Sweden.
Umeå University, Sweden.
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2017 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 45, no 4, 519-532 p.Article in journal (Refereed) Published
Abstract [en]

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 amp;lt; 0.0001). Non-response at 3 months was an independent predictor of subsequent colectomy (HR = 9.40, 95% CI = 5.10-17.35, P amp;lt; 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.

Place, publisher, year, edition, pages
WILEY-BLACKWELL , 2017. Vol. 45, no 4, 519-532 p.
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-136066DOI: 10.1111/apt.13893ISI: 000393790200004PubMedID: 28025840OAI: oai:DiVA.org:liu-136066DiVA: diva2:1084809
Note

Funding Agencies|Thorsten-Segerfalks Foundation [86026]; Olle Olsson Memory Foundation [86030]; Stig and Ragna Gorthons Foundation [2013-92, 2014-149, 2015-1259]

Available from: 2017-03-27 Created: 2017-03-27 Last updated: 2017-03-27

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Hjortswang, Henrik
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Department of Medical and Health SciencesFaculty of Medicine and Health SciencesDepartment of Gastroentorology
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