title: Impact of mucosal healing on long-term outcomes in ulcerative colitis treated with infliximab: a multicenter experience.
abstract: BACKGROUND
  Mucosal healing can be achieved with infliximab (IFX).
  
  
  OBJECTIVE
  To assess the impact of mucosal healing on long-term outcomes in patients with ulcerative colitis (UC) when treated with infliximab (IFX) beyond 1 year.
  
  
  METHODS
  All consecutive adult patients with refractory UC receiving maintenance treatment with IFX in five French referral centres were analysed retrospectively. Only patients who had endoscopic evaluation between 6 and 52 weeks following IFX initiation were included. According to their Mayo endoscopic sub-score, patients were categorised into mucosal healing (sub-score: 0-1) and no mucosal healing (2-3). Outcome measures were colectomy and IFX failure defined by drug withdrawal due to secondary failure among primary responders.
  
  
  RESULTS
  Of the 63 patients (30 women; median age: 38 years), 30 (48%) achieved mucosal healing. The median follow-up duration was 27 (3-79) months. Colectomy-free survival rates at 12, 24 and 36 months were, respectively, 100%, 96% and 96% in patients with mucosal healing. The corresponding figures were, respectively, 80%, 65% and 65% in patients without mucosal healing (P = 0.004). By multivariate analysis, mucosal healing was the only factor associated with colectomy-free survival, with an odds ratio of 18.01 (95%CI: 1.58-204.92). IFX failure-free survival rates at 12, 24 and 36 months were, respectively, 76%, 69% and 64% in patients with mucosal healing, and 44%, 25% and 21% in those without mucosal healing (P = 0.003).
  
  
  CONCLUSIONS
  Patients with refractory UC who achieved mucosal healing after IFX initiation had better long-term outcomes, with significantly less colectomy and less IFX failure.
authors.affiliation: Service d'Hépato-gastroentérologie, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France. david.laharie@chu-bordeaux.fr
authors.forename: D
authors.initials: D
authors.lastname: Laharie
authors.forename: J
authors.initials: J
authors.lastname: Filippi
authors.forename: X
authors.initials: X
authors.lastname: Roblin
authors.forename: S
authors.initials: S
authors.lastname: Nancey
authors.forename: J-B
authors.initials: JB
authors.lastname: Chevaux
authors.forename: X
authors.initials: X
authors.lastname: Hébuterne
authors.forename: B
authors.initials: B
authors.lastname: Flourié
authors.forename: M
authors.initials: M
authors.lastname: Capdepont
authors.forename: L
authors.initials: L
authors.lastname: Peyrin-Biroulet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005602:France; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D007413:Intestinal Mucosa / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab