Infliximab for refractory ulcerative proctitis.
BACKGROUND
Efficacy of infliximab in treating ulcerative proctitis remains unknown.


OBJECTIVE
To evaluate the clinical, biological and endoscopic efficacy of infliximab therapy in refractory proctitis.


METHODS
The charts of 420 patients treated with infliximab for ulcerative colitis were reviewed. Thirteen patients were treated with infliximab for refractory ulcerative proctitis in six referral centres between 2005 and 2009.


RESULTS
Following infliximab therapy induction, 9/13 patients (69%) had a complete response (defined as absence of diarrhoea and blood), 2/13 (15%) had a partial response and 2/13 (15%) were primary nonresponders. The median follow-up was 17 months (range, 3-48). Among the 11 patients with clinical response after infliximab induction therapy, 9 (82%) patients maintained response at last follow-up. Disappearance of rectal disorders was observed in all nine patients who maintained clinical response at last follow-up. Following infliximab induction therapy, the mean CRP level fell from 12.8 mg/L to 4.7 mg/L. Endoscopic evaluation was performed before and after infliximab in seven patients, showing an improvement in mucosal lesions in four patients, persistent mild endoscopic activity in two patients and no improvement in one patient. One patient underwent proctocolectomy.


CONCLUSIONS
Infliximab therapy seems to be effective in inducing and maintaining a clinical response in refractory ulcerative proctitis.
Bouguen
G
G
Inserm, Department of Hepato-Gastroenterology, University Hospital of Rennes, Pontchaillou, France.
Roblin
X
X
Bourreille
A
A
Feier
L
L
Filippi
J
J
Nancey
S
S
Bretagne
J-F
JF
Flourié
B
B
Hébuterne
X
X
Bigard
M-A
MA
Siproudhis
L
L
Peyrin-Biroulet
L
L
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab