Background & Aims: This observational study assessed long term clinical benefit of infliximab (IFX) in 614 consecutive Crohn's disease (CD) patients from a single centre during a median follow-up (FU) of 55 months (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 FU. Long-term effects of IFX on the course of CD as reflected by the rate of surgeries and hospitalizations and need for corticosteroids were also analyzed.
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 therapy. In 68.3% of these therapy 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 for side effects and 118 (21.6%) for 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 hospitalizations and surgeries 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 CD patients long-term therapy with IFX was very efficacious to maintain improvement during a median FU of almost 5 years and changed disease outcome by decreasing the rate of hospitalizations and surgeries.