Long-term outcome of treatment with infliximab in 614 patients with Crohn’s disease: results from a single-centre cohort
- F Schnitzler1,
- H Fidder1,
- M Ferrante1,
- M Noman1,
- I Arijs1,
- G Van Assche1,
- I Hoffman2,
- K Van Steen3,
- S Vermeire1,
- P Rutgeerts1
- 1Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium
- 2Department of Paediatric Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium
- 3Department of Electrical Engineering and Computer Science-Montefiore Institute, University of Liege, Belgium
- Professor P Rutgeerts, Department of Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium;
- Revised 14 July 2008
- Accepted 5 August 2008
- Published Online First 2 October 2008
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.
Competing interests: None.
See Commentary, p 477