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Impact of mucosal healing on long-term outcomes in ulcerative colitis treated with infliximab: a multicenter experience

Abstract : BACKGROUND: Mucosal healing can be achieved with infliximab (IFX). AIM: To assess the impact of mucosal healing on long-term outcomes in patients with ulcerative colitis (UC) when treated with infliximab (IFX) beyond 1 year. METHODS: All consecutive adult patients with refractory UC receiving maintenance treatment with IFX in five French referral centres were analysed retrospectively. Only patients who had endoscopic evaluation between 6 and 52 weeks following IFX initiation were included. According to their Mayo endoscopic sub-score, patients were categorised into mucosal healing (sub-score: 0-1) and no mucosal healing (2-3). Outcome measures were colectomy and IFX failure defined by drug withdrawal due to secondary failure among primary responders. RESULTS: Of the 63 patients (30 women; median age: 38 years), 30 (48%) achieved mucosal healing. The median follow-up duration was 27 (3-79) months. Colectomy-free survival rates at 12, 24 and 36 months were, respectively, 100%, 96% and 96% in patients with mucosal healing. The corresponding figures were, respectively, 80%, 65% and 65% in patients without mucosal healing (P = 0.004). By multivariate analysis, mucosal healing was the only factor associated with colectomy-free survival, with an odds ratio of 18.01 (95%CI: 1.58-204.92). IFX failure-free survival rates at 12, 24 and 36 months were, respectively, 76%, 69% and 64% in patients with mucosal healing, and 44%, 25% and 21% in those without mucosal healing (P = 0.003). CONCLUSION: Patients with refractory UC who achieved mucosal healing after IFX initiation had better long-term outcomes, with significantly less colectomy and less IFX failure.
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https://hal.univ-lorraine.fr/hal-01703099
Contributor : Ngere Ul Connect in order to contact the contributor
Submitted on : Wednesday, February 7, 2018 - 2:53:51 PM
Last modification on : Wednesday, October 14, 2020 - 3:11:46 AM

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D. Laharie, J. Filippi, X. Roblin, S. Nancey, J. B. Chevaux, et al.. Impact of mucosal healing on long-term outcomes in ulcerative colitis treated with infliximab: a multicenter experience. Alimentary Pharmacology & Therapeutics (Suppl), 2013, 37 (10), pp.998 - 1004. ⟨10.1111/apt.12289⟩. ⟨hal-01703099⟩

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