Infliximab dependency is related to decreased surgical rates in adult Crohn's disease patients

TY - JOUR

T1 - Infliximab dependency is related to decreased surgical rates in adult Crohn's disease patients

AU - Pedersen, N.

AU - Duricova, D.

AU - Lenicek, M.

AU - Elkjaer, M.

AU - Bortlik, M.

AU - Andersen, P.S.

AU - Vitek, L.

AU - Davidsen, B.

AU - Wewer, V.

AU - Lukas, Manuel Sebastian

AU - Munkholm, P.

PY - 2010/10

Y1 - 2010/10

N2 - Background: Infliximab dependency in children with Crohn's disease (CD) has recently been described and found to be associated with a decreased surgery rate. AIM: To assess infliximab dependency of adult CD patients, evaluate the impact on surgery, and search for possible clinical and genetic predictors. Methods: Two hundred and forty-five CD patients treated with infliximab were included from Danish and Czech Crohn Colitis Database (1999-2006). Infliximab response was assessed as immediate outcome, 1 month after infliximab start: complete, partial, and no response. Three months outcome, after last intended infusion: prolonged response (maintenance of complete/partial response), infliximab dependency (relapse requiring repeated infusions to regain complete/partial response or need of infliximab >12 months to sustain response). Results: Forty-seven percent obtained prolonged response, 29% were infliximab dependent and 24% nonresponders. The cumulative probability of surgery 40 months after infliximab start was 20% in prolonged responders, 23% in infliximab-dependent patients and 76% in nonresponders (P<0.001). The cumulative probability of surgery at 40 months in patients on maintenance versus on demand regime was 33 and 31%, respectively (P=0.63). No relevant clinical or genetic predictors were identified. Conxlusion: The infliximab dependency response seems to be equivalent to the prolonged response in adult CD patients when comparing surgery rates.

AB - Background: Infliximab dependency in children with Crohn's disease (CD) has recently been described and found to be associated with a decreased surgery rate. AIM: To assess infliximab dependency of adult CD patients, evaluate the impact on surgery, and search for possible clinical and genetic predictors. Methods: Two hundred and forty-five CD patients treated with infliximab were included from Danish and Czech Crohn Colitis Database (1999-2006). Infliximab response was assessed as immediate outcome, 1 month after infliximab start: complete, partial, and no response. Three months outcome, after last intended infusion: prolonged response (maintenance of complete/partial response), infliximab dependency (relapse requiring repeated infusions to regain complete/partial response or need of infliximab >12 months to sustain response). Results: Forty-seven percent obtained prolonged response, 29% were infliximab dependent and 24% nonresponders. The cumulative probability of surgery 40 months after infliximab start was 20% in prolonged responders, 23% in infliximab-dependent patients and 76% in nonresponders (P<0.001). The cumulative probability of surgery at 40 months in patients on maintenance versus on demand regime was 33 and 31%, respectively (P=0.63). No relevant clinical or genetic predictors were identified. Conxlusion: The infliximab dependency response seems to be equivalent to the prolonged response in adult CD patients when comparing surgery rates.

U2 - 10.1097/meg.0b013e32833dde2e

DO - 10.1097/meg.0b013e32833dde2e

M3 - Journal article

SN - 0954-691X

VL - 22

SP - 1196

EP - 1203

JO - European Journal of Gastroenterology and Hepatology

JF - European Journal of Gastroenterology and Hepatology

IS - 10

ER -