title: Experience of maintenance infliximab therapy for refractory ulcerative colitis from six centres in England.
abstract: BACKGROUND
  Infliximab is used for treatment of Crohn's disease and, following the Active Ulcerative Colitis Trials (ACT) 1 and 2, it has been used as rescue and maintenance therapy in moderate and severe ulcerative colitis (UC).
  
  
  OBJECTIVE
  To report on English experience with maintenance infliximab in terms of response and colectomy rates and side-effect profile in UC.
  
  
  METHODS
  A retrospective audit conducted by using a web-based questionnaire filled in by 12 gastroenterologists from six English centres.
  
  
  RESULTS
  Of the 38 patients receiving induction with infliximab, 28 (73.6%) maintained an ongoing response (8-weekly infusions 5 mg/kg) for a mean duration of 16.8 months (range 4-59), with 21 (55.3%) being in remission. Three of 38 patients (7.9%) who also responded had a secondary loss of response after an average of 10 months (range 8-13); seven of 38 patients (18.4%) showed no response. The colectomy rate was seven of 38 (18.4%, five non-responders and two with secondary loss of response). Adverse effects occurred in five patients (13.2%). Two discontinued infliximab (alopecia, invasive breast cancer). The three less-severe adverse effects were acute and delayed-type hypersensitivity reactions and one persistent otitis media.
  
  
  CONCLUSIONS
  Our experience suggests acceptable response rates, colectomy rates and side-effect profile of maintenance therapy with infliximab in moderate and severe UC.
authors.affiliation: Imperial College Healthcare NHS Trust, London, UK.
authors.forename: E A
authors.initials: EA
authors.lastname: Russo
authors.forename: A W
authors.initials: AW
authors.lastname: Harris
authors.forename: S
authors.initials: S
authors.lastname: Campbell
authors.forename: J
authors.initials: J
authors.lastname: Lindsay
authors.forename: A
authors.initials: A
authors.lastname: Hart
authors.forename: N
authors.initials: N
authors.lastname: Arebi
authors.forename: A
authors.initials: A
authors.lastname: Milestone
authors.forename: H H
authors.initials: HH
authors.lastname: Tsai
authors.forename: J
authors.initials: J
authors.lastname: Walters
authors.forename: M
authors.initials: M
authors.lastname: Carpani
authors.forename: D
authors.initials: D
authors.lastname: Westaby
authors.forename: A
authors.initials: A
authors.lastname: Thillainayagam
authors.forename: D
authors.initials: D
authors.lastname: Bansi
authors.forename: S
authors.initials: S
authors.lastname: Ghosh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003082:Colectomy / Q000706:statistics & numerical data*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab