A Multicenter Experience With Infliximab for Ulcerative Colitis: Outcomes and Predictors of Response, Optimization, Colectomy, and Hospitalization

Oussalah, Abderrahim; Evesque, Ludovic; Laharie, David; Roblin, Xavier; Boschetti, Gilles; Nancey, Stéphane; Filippi, Jérôme; Flourié, Bernard; Hébuterne, Xavier; Bigard, Marc‐André; Peyrin–Biroulet, Laurent

doi:10.1038/ajg.2010.345

Cited by 163 publications

(137 citation statements)

References 25 publications

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“…Intensification predictors might be interpreted as predictors of loss of response. Severe colitis forms were identified as a predictor of intensification in a retrospective study of 80 patients on maintenance therapy (11). In our results indication did predict intensification in the univariate…”

Section: Discussionsupporting

confidence: 49%

“…This intensification rate is much lower than shown in other studies (1,3,6,(10)(11)(12). In the study by Ferrante et al nearly 40% of the 73 patients on maintenance with IFX were intensified (10), and a Spanish study also shows an intensification rate of 40% in the setting of UC (3).…”

Section: Discussioncontrasting

confidence: 39%

“…Ten of the 36 patients with shortened intervals were de-intensified after 12 months (IQR, [4][5][6][7][8][9][10][11][12][13][14][15][16], and 3 of these were again re-intensified. Two of the seven patients with increased doses were de-intensified after 2 and 4 months, respectively.…”

Section: De-intensificationmentioning

confidence: 99%

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Frequency, predictors, and consequences of maintenance infliximab therapy intensification in ulcerative colitis

et al. 2015

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Introduction: Infliximab (IFX) therapy intensification in ulcerative colitis (UC) is more common than established in pivotal studies.Objectives: To establish the frequency and form of intensification for UC in clinical practice, as well as predictors, and to compare outcomes between intensified and non-intensified treatment.Methods: A retrospective study of 10 hospitals and 144 patients with response to infliximab (IFX) induction. Predictive variables for intensification were analyzed using a Cox regression analysis. Outcome, loss of response to IFX, and colectomy were compared between intensified and non-intensified therapy.Results: Follow-up time from induction to data collection: 38 months [interquartile range (IQR), 20-62]. Time on IFX therapy: 24 months (IQR, 10-44). In all, 37% of patients required intensification. Interval was shortened for 36 patients, dose was increased for 7, and 10 subjects received both. Concurrent thiopurine immunosuppressants (IMM) and IFX initiation was an independent predictor of intensification [Hazard ratio, 0.034; p, 0.006; CI,. In patients on intensified therapy IFX discontinuation for loss of response (30.4% vs. 10.2%; p, 0.002), steroid reintroduction (35% vs. 18%; p, 0.018), and colectomy (22% vs. 6.4%; p, 0.011) were more common. Of patients on intensification, 17% returned to receiving 5 mg/kg every 8 weeks.

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Section: Discussionsupporting

confidence: 49%

Section: Discussioncontrasting

confidence: 39%

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Frequency, predictors, and consequences of maintenance infliximab therapy intensification in ulcerative colitis

et al. 2015

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“…These rates of treatment failure are lower than those reported in the ACT 1 and ACT 2 trials, in which 31.6 and 36.5% of the patients, respectively, did not respond to IFX after 8 weeks. A recent French study observed a rate of primary nonresponse of 22% and a need for IFX dose optimization in 45% of the subjects [19]. In the Belgian study [15], 39% of the patients required dose optimization.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Infliximab in Moderate to Severe Ulcerative Colitis in a Latin American Referral Population

Juliao

Márquez²,

Aristizabal³

et al. 2013

Digestion

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Background: Previous research has shown that infliximab (IFX) is effective in the management of moderate to severe active ulcerative colitis (UC). Latin American studies are lacking. Aim: To evaluate the efficacy of IFX treatment (including corticosteroid withdrawal, complete mucosal healing, colectomy and hospitalization rates) in patients with moderate to severe UC. Methods: A retrospective and descriptive study was conducted on patients with UC in Medellín (Colombia). We included patients steroid dependent or refractory to conventional treatment. Results: Between October 2005 and July 2011, 28 patients with moderate to severe UC received IFX infusions; the median of the follow-up was 27.4 months (range: 1-69 months). Twenty-four patients (86%) had a short-term primary response, whilst 19 (68%) achieved initial clinical remission. After 1 year, 17 (71%) out of the 24 patients who had an initial response were also showing a sustained response, and 10 (42%) remained in clinical remission. At 6 months, complete mucosal healing was observed in 29% of patients and endoscopic improvement in 57%. Conclusions: This is the first study to evaluate the IFX use in patients with moderate to severe active UC in a Latin American population. We found that IFX therapy is effective for inducing clinical remission, and that most patients who had an initial response showed a long-term sustained response.

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“…Previous failure of corticosteroid or cyclosporine treatment is also associated with increased risk of therapeutic failure in UC [Ferrante et al 2008;Oussalah et al 2010]. Initial response to treatment, manifested by early clinical remission and mucosal healing, is associated with improved durability of response [Colombel et al 2011].…”

Section: Inflammatory Biomarkersmentioning

confidence: 99%

Predicting durable response or resistance to antitumor necrosis factor therapy in inflammatory bowel disease

Kopylov

Seidman

2016

Therap Adv Gastroenterol

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Monoclonal antibodies to tumor necrosis factor (TNF) have become a mainstay of the therapeutic armamentarium in inflammatory bowel disease (IBD) over the last 15 years. Although highly effective, primary and secondary nonresponse are common and associated with poor clinical outcomes and significant costs. Multiple clinical, genetic and immunopharmacological factors may impact the response to anti-TNFs. Early stratification of IBD patients by the expected risk of therapeutic failure during the induction and maintenance phases of treatment may allow for treatment optimization and potentially optimal short-and long-term outcomes. The aim of this review is to summarize the current data concerning the potential predictors of therapeutic success and failure of anti-TNFs in IBD.

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A Multicenter Experience With Infliximab for Ulcerative Colitis: Outcomes and Predictors of Response, Optimization, Colectomy, and Hospitalization

Cited by 163 publications

References 25 publications

Frequency, predictors, and consequences of maintenance infliximab therapy intensification in ulcerative colitis

Frequency, predictors, and consequences of maintenance infliximab therapy intensification in ulcerative colitis

Clinical Efficacy of Infliximab in Moderate to Severe Ulcerative Colitis in a Latin American Referral Population

Predicting durable response or resistance to antitumor necrosis factor therapy in inflammatory bowel disease

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