title: Clinical evolution of luminal and perianal Crohn's disease after inducing remission with infliximab: how long should patients be treated?
abstract: BACKGROUND
  Few data are available regarding the evolution of Crohn's disease after discontinuing a successful course of infliximab.
  
  
  OBJECTIVE
  To evaluate clinical outcome of Crohn's disease after induction of remission with three infliximab infusions (luminal disease) and after maintenance of remission with 1-year course of infliximab every 8 weeks (luminal and perianal).
  
  
  METHODS
  Twenty-three patients with active luminal Crohn's disease who responded to three infusions of infliximab (0, 2, and 6 weeks), and 23 patients with sustained response to infliximab every 8 weeks during 1 year, were included. Patients were followed-up until relapse or for at least 6 months after infliximab discontinuation. Clinical outcomes and factors associated to relapse were evaluated.
  
  
  RESULTS
  In luminal Crohn's disease, a three-infusion infliximab regimen achieved a sustained response in most patients, especially if a complete response occurred at the time of the third infusion. In patients treated for 1-year, infliximab discontinuation was also successful, with a cumulative probability of being free of relapse of 69% at 12 months. In perianal disease, early relapse was the rule after stopping infliximab treatment, with only 34% of patient maintaining remission at 1 year.
  
  
  CONCLUSIONS
  Short regimens of infliximab might be evaluated in patients with luminal Crohn's disease. However, infliximab discontinuation is not recommended in perianal Crohn's disease, because of a high rate of early relapse.
authors.affiliation: Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain. domenech@ns.hugtip.scs.es
authors.forename: E
authors.initials: E
authors.lastname: Domènech
authors.forename: J
authors.initials: J
authors.lastname: Hinojosa
authors.forename: P
authors.initials: P
authors.lastname: Nos
authors.forename: E
authors.initials: E
authors.lastname: Garcia-Planella
authors.forename: E
authors.initials: E
authors.lastname: Cabré
authors.forename: I
authors.initials: I
authors.lastname: Bernal
authors.forename: M A
authors.initials: MA
authors.lastname: Gassull
mesh_terms: D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy*; D018572:Disease-Free Survival; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab