Austrian infliximab experience in Crohn's disease: a nationwide cooperative study with long-term follow-up.
OBJECTIVE
To determine the nationwide experience with infliximab for the treatment of Crohn's disease in Austria.


METHODS
National multicentre retrospective postal questionnaire survey.


METHODS
All institutions using infliximab for Crohn's disease in the years 1999 and 2000 were identified by the registry of the local provider of this drug.


METHODS
Response after first treatment course according to physician global assessment, number of subsequent infliximab infusions, disease activity at end of follow-up, avoidance of steroids, frequency of surgery for Crohn's disease, and adverse events.


RESULTS
Questionnaires were returned by 32/35 (91%) centres approached. A total of 748 infusions were administered to 153 patients. After the first treatment course an excellent or good response occurred in 48/58 (83%) patients with luminal disease, and in 67/95 (71%) patients with fistulous disease (P < 0.05). After the first treatment course 108 (71%) patients received further infliximab therapy. At a mean follow-up of 29 months, 50% of patients had improved since baseline without requiring surgery for Crohn's disease. Steroid withdrawal was achieved in 25% of patients. Surgery had been performed in one-third of patients and was associated with lacking response to the first treatment course (P < 0.001) and with fistulous disease (P = 0.012). Co-medication with azathioprine favoured the initial response and steroid withdrawal (P < 0.05). One patient died from myocarditis; other adverse events were consistent with that seen in other studies of infliximab.


CONCLUSIONS
The Austrian experience with infliximab for Crohn's disease is in general accordance with results from clinical trials and post-marketing studies from single centres. A substantial subgroup of patients appear to have a prolonged benefit from infliximab therapy.
Wenzl
Heimo H
HH
Department of Internal Medicine, Karl-Franzens University Graz, Austria.
Reinisch
Walter
W
Jahnel
Jörg
J
Stockenhuber
Felix
F
Tilg
Herbert
H
Kirchgatterer
Andreas
A
Petritsch
Wolfgang
W
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D001317:Austria; D001424:Bacterial Infections / Q000209:etiology; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D008297:Male; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab