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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Gastroenterology 1/2014

Long-term efficacy of infliximab for refractory ulcerative colitis: results from a single center experience

Zeitschrift:
BMC Gastroenterology > Ausgabe 1/2014
Autoren:
Satoshi Yamada, Takuya Yoshino, Minoru Matsuura, Naoki Minami, Takahiko Toyonaga, Yusuke Honzawa, Yoshihisa Tsuji, Hiroshi Nakase
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-230X-14-80) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SY, TY, MM and HN designed the study. SY performed the major role of collecting patients’ data and wrote the manuscript. NM, TT, YH TY, MM and HN collected patients’ data and were involved in editing the manuscript. YT performed the statistical analysis. All authors read and approved the final manuscript.

Abstract

Background

The long-term efficacy of infliximab (IFX) for patients with refractory ulcerative colitis (UC) is unclear. The aim of this study was to assess the long-term outcomes of IFX treatment in patients with refractory UC.

Methods

Thirty-three patients with refractory UC who received IFX treatment at Kyoto University Hospital between 2003 and 2013 were retrospectively evaluated. IFX intensification was defined as a dose escalation (up to 10 mg/kg) and/or shorter intervals between infusions (every 4–6 weeks).

Results

Of the 33 patients who received scheduled infusions of IFX, 24 (72.7%) achieved clinical remission within 8 weeks after initiating IFX treatment. Of these 24 responders, 17 (70.8%) experienced a relapse of UC and required IFX intensification, and 16 (66.7%) eventually maintained clinical remission with IFX treatment, including IFX intensification. Of the 33 patients, 6 (18.2%) underwent colectomy during IFX treatment. Multivariate regression analysis showed that a serum C-reactive protein (CRP) concentration <5 mg/L two weeks after starting IFX was a predictor of a positive clinical response to IFX induction therapy. No severe adverse events occurred in UC patients treated with IFX.

Conclusion

IFX intensification was necessary for long-term maintenance of remission and to prevent colectomy in patients with refractory UC.
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