The tolerance and efficacy of a postponed retreatment with infliximab in Crohn's disease primary responders.
BACKGROUND
In Crohn's disease (CD) patients naïve to immunomodulators primary responding to infliximab (IFX) induction, maintenance with scheduled IFX or with immunomodulators is possible. The benefit of additional IFX infusions after failure of maintenance with immunomodulators is not known.


OBJECTIVE
To assess the efficacy and factors associated with efficacy of postponed IFX retreatment.


METHODS
All CD primary responders to an IFX induction regimen in maintenance with immunomodulators were retrospectively included when they received at least one additional IFX infusion after week 14. Efficacy was defined as clinical response at week 4 and absence of intolerance leading to discontinuation.


RESULTS
Sixty-one patients were retreated with IFX with a 38-week median time from induction. Efficacy was achieved in 80% patients. Twelve patients had no clinical benefit: seven acute hypersensitivity reactions and five loss of response. By multivariate analysis, the only factor associated with no efficacy was a median time >50 weeks from induction to retreatment (odds ratio = 7.38; 95%CI: 1.38-39.59; P = 0.02).


CONCLUSIONS
Postponed retreatment with IFX in CD primary responders should be administered within 50 weeks after induction, for better efficacy and tolerance.
CHU Bordeaux, Hôpital Haut-Leveque Hospital, Service d'Hepato-gastroenterologie, Pessac, France. david.laharie@chu-bordeaux.fr
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Laharie
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Chanteloup
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Chabrun
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Subtil
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Kowo
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El Hanafi
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DE Lédinghen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D003424:Crohn Disease / Q000628:therapy*; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006801:Humans; D000069285:Infliximab; D008875:Middle Aged; D015999:Multivariate Analysis; D012016:Reference Values; D019233:Retreatment; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab