title: Predictors of relapse in patients with ulcerative colitis in remission after one-year of infliximab therapy.
abstract: BACKGROUND. Some of the most important questions relating to the use of biological therapy in inflammatory bowel diseases concern the duration of maintenance therapy. The RASH study revealed that previous use of biological therapy and dose intensification are associated with restarting of biological therapy in Crohn's disease. The aim of the study was to assess the disease course and frequency of relapse of ulcerative colitis (UC) following discontinuation of infliximab in patients with remission and to determine predictive factors for relapse. PATIENTS AND METHODS. Fifty-one UC patients who had achieved clinical remission following 1 year of infliximab therapy and for whom infliximab was then discontinued participated in this prospective observational study. 15.7% of the patients received infliximab before the 1-year period of biological therapy analyzed in the study. Biological therapy was restarted in case of recurrent clinical activity. Data were collected from four Hungarian IBD centers. RESULTS. Thirty-five percent of the patients needed to be retreated with infliximab within 1 year after treatment cessation. Logistic regression analysis revealed that previous biological therapy (p = 0.021) was associated with the need of restarting infliximab. None of the data relating to patients' demographic and clinical characteristics, concomitant therapy and CRP level showed association with the need for restarting biological therapy. CONCLUSIONS. Biological therapy was restarted at a median of 4 months after discontinuation in more than every third UC patients who had been in clinical remission following 1 year of infliximab therapy. Response to retreatment with infliximab was favorable in the majority of the patients who relapsed.
authors.affiliation: 1st Department of Medicine, University of Szeged , Szeged , Hungary.
authors.forename: Klaudia
authors.initials: K
authors.lastname: Farkas
authors.forename: Péter László
authors.initials: PL
authors.lastname: Lakatos
authors.forename: Ferenc
authors.initials: F
authors.lastname: Nagy
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szepes
authors.forename: Pál
authors.initials: P
authors.lastname: Miheller
authors.forename: Mária
authors.initials: M
authors.lastname: Papp
authors.forename: Károly
authors.initials: K
authors.lastname: Palatka
authors.forename: Anita
authors.initials: A
authors.lastname: Bálint
authors.forename: Renáta
authors.initials: R
authors.lastname: Bor
authors.forename: Tibor
authors.initials: T
authors.lastname: Wittmann
authors.forename: Tamás
authors.initials: T
authors.lastname: Molnár
mesh_terms: D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy; D000069285:Infliximab; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D000069285:Infliximab