Maintenance of clinical benefit in Crohn's disease patients after discontinuation of infliximab: long-term follow-up of a single centre cohort.

Abstract

BACKGROUND:

Tumour necrosis factor-blockade with infliximab has advanced the treatment of Crohn's disease. While infliximab is efficacious, it remains to be determined whether patients who enter clinical remission with an anti-tumour necrosis factor therapy can have their treatment stopped and retain the state of remission.

AIM:

To assess in patients with Crohn's disease who obtained infliximab-induced remission, the proportion who relapsed after infliximab discontinuation.

METHODS:

This longitudinal cohort study examined patients from a University-based IBD referral centre. Forty eight patients with Crohn's disease in full clinical remission and who then discontinued infliximab were followed up for up to 7 years. Crohn's disease relapse was defined as an intervention with Crohn's disease medication or surgery.

RESULTS:

Kaplan-Meier analysis of the proportion of patients with sustained clinical benefit demonstrated that 50% relapsed within 477 days after infliximab discontinuance. In contrast, 35% of patients remained well, and without clinical relapse, up to the end of the nearly 7-year follow-up.

CONCLUSIONS:

In patients with Crohn's disease with an infliximab-induced remission, stopping infliximab results in a predictable relapse in a majority of patients. Nevertheless, a small percentage of patients sustain a long-term remission.

• Authors: A W G Waugh, S Garg, K Matic, L Gramlich, C Wong, D C Sadowski, M Millan, R Bailey, D Todoruk, R Cherry, C W Teshima, L Dieleman, R N Fedorak
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 32 Issue 9 Pg. 1129-34 (Nov 2010) ISSN: 1365-2036 [Electronic] England
• PMID: 20807218 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2010 Blackwell Publishing Ltd.

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Tumor Necrosis Factor-alpha
• Infliximab

Topics

• Adult
• Anti-Inflammatory Agents (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Cohort Studies
• Crohn Disease (drug therapy)
• Female
• Follow-Up Studies
• Humans
• Infliximab
• Longitudinal Studies
• Male
• Remission Induction
• Time Factors
• Treatment Outcome
• Tumor Necrosis Factor-alpha (therapeutic use)
• Young Adult