Outcomes of long-term maintenance infliximab therapy in adult patients with moderate to severe Crohn's disease from March 2003 to December 2010: A single centre experience
Abstrakt
We evaluated the long-term clinical benefit of infliximab (IFX) in a total of 74 patients with moderate to severe Crohn's disease (CD); the median follow-up was 16 months (interquartile range 13-35). Methods: We compared the quality of mucosal healing (MH) in 3 groups of patients with CD.
Group I (GI): CD duration 3 years, treated with IFX. Group III (GIII): CD duration > 3 years, treated with IFX + azathioprine (AZA).
Results: At week 52, deep clinical remission was observed in seven of 21 patients in GI (33.33%), in three of 19 patients in GII (15.70%), and in eight of 20 patients in GIII (40.00%). The differences among groups were statistically significant in the likelihood ratio test (P = 0.019) and logrank test (P = 0.042).
The covariate analysis showed significant differences in the outcomes between GIII and GII (OR 7.20, P = 0.05) and between GI and GII (OR 6.3, P = 0.052), and a nonsignificant difference between GIII and GI (OR 1.143, P = 0.975). Sustained long-term clinical benefit was observed in 47 (63.9%) of the initial responders.
Conclusion: IFX and AZA combination therapy was highly effective in patients with CD duration > 3 years after failure of conventional therapy. Timely IFX monotherapy works best in patients with evidence of active inflammation as demonstrated by an elevated C-reactive protein and in patients with nonstricturing disease.