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Gut 58:492-500 doi:10.1136/gut.2008.155812
  • Inflammatory bowel disease

Long-term outcome of treatment with infliximab in 614 patients with Crohn’s disease: results from a single-centre cohort

  1. F Schnitzler1,
  2. H Fidder1,
  3. M Ferrante1,
  4. M Noman1,
  5. I Arijs1,
  6. G Van Assche1,
  7. I Hoffman2,
  8. K Van Steen3,
  9. S Vermeire1,
  10. P Rutgeerts1
  1. 1
    Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium
  2. 2
    Department of Paediatric Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium
  3. 3
    Department of Electrical Engineering and Computer Science-Montefiore Institute, University of Liege, Belgium
  1. Professor P Rutgeerts, Department of Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium; paul.rutgeerts{at}uz.kuleuven.be
  • Revised 14 July 2008
  • Accepted 5 August 2008
  • Published Online First 2 October 2008

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.

Footnotes

  • Competing interests: None.

  • See Commentary, p 477