Factors Associated with Durable Response to Infliximab in Crohnʼs Disease 5 Years and Beyond: A Multicenter International Cohort

Juillerat, Pascal; Sokol, Harry; Froehlich, Florian; Yajnik, Vijay; Beaugerie, Laurent; Lucci, Matthew; Burnand, Bernard; Macpherson, Andrew; Cosnes, Jacques; Korzenik, Joshua R. (2015). Factors Associated with Durable Response to Infliximab in Crohnʼs Disease 5 Years and Beyond: A Multicenter International Cohort. Inflammatory bowel diseases, 21(1), pp. 60-70. Lippincott Williams & Wilkins 10.1097/MIB.0000000000000225

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BACKGROUND: Infliximab (IFX) has been used for over a decade worldwide. Less is known about the natural history of IFX use beyond a few years and which patients are more likely to sustain benefits. METHODS: Patients with Crohn's disease (CD) exposed to IFX from Massachusetts General Hospital, Boston, Saint-Antoine Hospital, Paris, and the Swiss IBD Cohort Study were identified through retrospective and prospective data collection, complemented by chart abstraction of electronic medical records. We compared long-term users of IFX (>5 yr of treatment, long-term users of infliximab [LTUI]), with non-LTUI patients to identify prognostic factors. RESULTS: We pooled data on 1014 patients with CD from 3 different databases, of whom 250 were defined as LTUI. The comparison group comprised 290 patients with CD who discontinued IFX: 48 primary nonresponses, 95 loss of responses, and 147 adverse events. Factors associated with LTUI were colonic involvements and an earlier age at the start of IFX. The prevalence of active smokers and obese patients differed markedly, but inversely, between American and European centers but did not impact outcome. The discontinuation rate was stable around 3% to 6%, each year from years 3 to 10. CONCLUSIONS: Young age at start of IFX and colonic CD are factors associated with a beneficial long-term use of IFX. After 5 years of IFX, there is still a 3% to 5% discontinuation rate annually. Several factors associated with a good initial response such as nonsmoker and shorter disease duration at IFX initiation do not seem associated with a longer term response.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology

UniBE Contributor:

Juillerat, Pascal and Macpherson, Andrew

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1078-0998

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

30 Mar 2015 11:22

Last Modified:

13 Oct 2017 07:53

Publisher DOI:

10.1097/MIB.0000000000000225

PubMed ID:

25517594

Uncontrolled Keywords:

Crohn’s disease, inflammatory bowel disease, infliximab, long-term, clinical, response

BORIS DOI:

10.7892/boris.66969

URI:

https://boris.unibe.ch/id/eprint/66969

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