title: Severe disease activity and cytomegalovirus colitis are predictive of a nonresponse to infliximab in patients with ulcerative colitis.
abstract: OBJECTIVE
  The role of infliximab in the treatment of patients with ulcerative colitis (UC) in Asia is still unclear. The aim of this study was to evaluate the clinical outcomes of infliximab therapy in Korean UC patients, including efficacy and predictors of response.
  
  
  METHODS
  Patients who received infliximab induction therapy for moderate to severe UC at Asan Medical Center were retrospectively analyzed. The demographic characteristics of these patients and their clinical outcomes following infliximab therapy were evaluated.
  
  
  RESULTS
  Of the 89 UC patients receiving infliximab induction therapy, 53 (59.6%) were steroid-refractory and 36 (40.4%) were steroid-dependent. At the initiation of infliximab, the median Mayo score was 9 (range 7-12). After the induction therapy of infliximab, 59 patients (66.3%) demonstrated a clinical response at week 8, of which 29 (32.6%) were determined to be in clinical remission. A colectomy was performed within 1 year after infliximab initiation in 11 (36.7%) of 30 patients who displayed no clinical response to infliximab therapy, but in none of the 59 patients who showed a response to this drug (p<0.001). Multivariate regression analysis identified severe disease (Mayo score≥11) at the initiation of infliximab (p=0.007) and history of cytomegalovirus colitis within 3 months prior to infliximab treatment (p=0.001) as independent positive predictors of nonresponse to infliximab.
  
  
  CONCLUSIONS
  The efficacy of infliximab in Korean UC patients seems to be similar to that of previously published Western reports. Severe disease and a history of cytomegalovirus colitis are predictors of a nonresponse to infliximab.
authors: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
authors: Sang Hyoung
authors: SH
authors: Park
authors: Suk-Kyun
authors: SK
authors: Yang
authors: Seung-Mo
authors: SM
authors: Hong
authors: Soo-Kyung
authors: SK
authors: Park
authors: Jong Wook
authors: JW
authors: Kim
authors: Hyo Jeong
authors: HJ
authors: Lee
authors: Dong-Hoon
authors: DH
authors: Yang
authors: Kee Wook
authors: KW
authors: Jung
authors: Kyung-Jo
authors: KJ
authors: Kim
authors: Byong Duk
authors: BD
authors: Ye
authors: Jeong-Sik
authors: JS
authors: Byeon
authors: Seung-Jae
authors: SJ
authors: Myung
authors: Jin-Ho
authors: JH
authors: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000382:microbiology; D003586:Cytomegalovirus Infections / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D000069285:Infliximab
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