Predictors of early response to infliximab in patients with ulcerative colitis.
BACKGROUND
Our objective is to report the outcome of infliximab (IFX) in ulcerative colitis (UC) patients from a single center and to identify predictors of early clinical response.


METHODS
The first 100 UC patients (45 female; median age, 37.9 years) who received IFX at a single center were included. Eighty-four patients received 5 mg/kg IFX, and 37 patients received a 3-dose IFX induction at weeks 0, 2, and 6. The Mayo endoscopic subscore, assessed by sigmoidoscopy before inclusion, was 1, 2, and 3 in 5%, 52%, and 43% of patients, respectively. Sixty percent had pancolitis, 63% were on concomitant immunosuppressive therapy, 9% were active smokers, 64% had C-reactive protein > or =5 mg/dL, and 44% were pANCA+/ASCA-. Five patients received IFX because of severe acute colitis refractory to intravenous corticosteroids.


RESULTS
Early complete and partial clinical responses were observed in 41% and 24% of patients. Patients with early clinical response were significantly younger than nonresponders (median age, 35.7 versus 41.6 years, P = 0.041). Patients who were pANCA+/ASCA- had a significantly lower early clinical response (55% versus 76%; odds ratio [OR] = 0.40 (0.16-0.99), P = 0.049). Concomitant immunosuppressive therapy and the use of an IFX induction scheme did not influence early clinical response. Only 1 of 5 patients who received IFX for acute steroid-refractory colitis required colectomy within 2 months.


CONCLUSIONS
IFX is an efficient therapy in UC, as shown by 65% early clinical response. A pANCA+/ASCA- serotype and an older age at first IFX infusion are associated with a suboptimal early clinical response.
Ferrante
Marc
M
Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium. marcferrante@yahoo.com
Vermeire
Séverine
S
Katsanos
Konstantinos H
KH
Noman
Maja
M
Van Assche
Gert
G
Schnitzler
Fabian
F
Arijs
Ingrid
I
De Hertogh
Gert
G
Hoffman
Ilse
I
Geboes
J Karel
JK
Rutgeerts
Paul
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001399:Azure Stains; D002648:Child; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D001399:Azure Stains; D005765:Gastrointestinal Agents; D000069285:Infliximab