BACKGROUND: Mucosal healing can be achieved with infliximab (IFX). AIM: To assess the impact of mucosal healing on long-term outcomes in patients with ulcerative colitis (UC) when treated with infliximab (IFX) beyond 1 year. METHODS: All consecutive adult patients with refractory UC receiving maintenance treatment with IFX in five French referral centres were analysed retrospectively. Only patients who had endoscopic evaluation between 6 and 52 weeks following IFX initiation were included. According to their Mayo endoscopic sub-score, patients were categorised into mucosal healing (sub-score: 0-1) and no mucosal healing (2-3). Outcome measures were colectomy and IFX failure defined by drug withdrawal due to secondary failure among primary responders. RESULTS: Of the 63 patients (30 women; median age: 38 years), 30 (48%) achieved mucosal healing. The median follow-up duration was 27 (3-79) months. Colectomy-free survival rates at 12, 24 and 36 months were, respectively, 100%, 96% and 96% in patients with mucosal healing. The corresponding figures were, respectively, 80%, 65% and 65% in patients without mucosal healing (P = 0.004). By multivariate analysis, mucosal healing was the only factor associated with colectomy-free survival, with an odds ratio of 18.01 (95%CI: 1.58-204.92). IFX failure-free survival rates at 12, 24 and 36 months were, respectively, 76%, 69% and 64% in patients with mucosal healing, and 44%, 25% and 21% in those without mucosal healing (P = 0.003). CONCLUSION: Patients with refractory UC who achieved mucosal healing after IFX initiation had better long-term outcomes, with significantly less colectomy and less IFX failure.
BACKGROUND: Mucosal healing can be achieved with infliximab (IFX). AIM: To assess the impact of mucosal healing on long-term outcomes in patients with ulcerative colitis (UC) when treated with infliximab (IFX) beyond 1 year. METHODS: All consecutive adult patients with refractory UC receiving maintenance treatment with IFX in five French referral centres were analysed retrospectively. Only patients who had endoscopic evaluation between 6 and 52 weeks following IFX initiation were included. According to their Mayo endoscopic sub-score, patients were categorised into mucosal healing (sub-score: 0-1) and no mucosal healing (2-3). Outcome measures were colectomy and IFX failure defined by drug withdrawal due to secondary failure among primary responders. RESULTS: Of the 63 patients (30 women; median age: 38 years), 30 (48%) achieved mucosal healing. The median follow-up duration was 27 (3-79) months. Colectomy-free survival rates at 12, 24 and 36 months were, respectively, 100%, 96% and 96% in patients with mucosal healing. The corresponding figures were, respectively, 80%, 65% and 65% in patients without mucosal healing (P = 0.004). By multivariate analysis, mucosal healing was the only factor associated with colectomy-free survival, with an odds ratio of 18.01 (95%CI: 1.58-204.92). IFX failure-free survival rates at 12, 24 and 36 months were, respectively, 76%, 69% and 64% in patients with mucosal healing, and 44%, 25% and 21% in those without mucosal healing (P = 0.003). CONCLUSION:Patients with refractory UC who achieved mucosal healing after IFX initiation had better long-term outcomes, with significantly less colectomy and less IFX failure.
Authors: Klaudia Farkas; Péter László Lakatos; Mónika Szűcs; Éva Pallagi-Kunstár; Anita Bálint; Ferenc Nagy; Zoltán Szepes; Noémi Vass; Lajos S Kiss; Tibor Wittmann; Tamás Molnár Journal: World J Gastroenterol Date: 2014-03-21 Impact factor: 5.742
Authors: Wing Yan Mak; Anthony Buisson; Michael J Andersen; Donald Lei; Joel Pekow; Russell D Cohen; Stacy A Kahn; Bruno Pereira; David T Rubin Journal: Dig Dis Sci Date: 2018-02-22 Impact factor: 3.199