title: Long-Term Follow-Up of Patients Treated with Infliximab for Ulcerative Colitis: Predictive Factors of Response-An Observational Study.
abstract: To evaluate the early and long-term efficacy of infliximab in ulcerative colitis and to determine predictors of response and colectomy.
  
  
  
  This is an ambidirectional cohort study in a tertiary referral center including patients who started infliximab within 2005 and 2008 and monitored until 2014. Efficacy was evaluated by partial Mayo scores at weeks 2, 4, 8, 30, and 54. Long-term treatment maintenance with infliximab and colectomy requirements were recorded.
  
  
  
  Fifty-three patients were included with a median follow-up of 69.5 months. Clinical remission at the time point assessments was 40.8, 47.2, 54.7, 54.7, and 49.1 %. At the time of maximal follow-up, the proportion of patients under infliximab maintenance was 24.5 %. A higher level of albumin (OR 1.4, CI 95 % 1.06-1.8; p = 0.017) was predictive of a higher remission rate at week 8. Concomitant immunomodulators beyond 6 months were predictive of infliximab's long-term maintenance (OR 15.8, CI 95 % 1.8-135.4; p = 0.012). Colectomy was required in 41.5 %. Factors associated with a higher rate of colectomy at week 54 were previous treatment with cyclosporine (OR 3.4, CI 95 % 1.2-9.7; p = 0.012), absence of response at week 8 (OR 10.3, CI 95 % 3.3-31.7; p < 0.001), and not receiving concomitant immunomodulators (OR 4.1, CI 95 % 1.8-9; p = 0.002). Colectomy rates within the first 54 weeks were closely dependent on the number of variables present: none (0 %), 1 (26.3 %), 2 (71.4 %), or 3 (100 %) of them (log rank <0.0001).
  
  
  
  Low albumin, previous treatment with cyclosporine, absence of a concomitant immunomodulator, and lack of response at week 8 negatively affected the efficacy of infliximab in ulcerative colitis.
authors.affiliation: Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Carrer Villarroel, 170, 08036, Barcelona, Spain. orlando.garcia@sanitatintegral.org.|Department of Digestive Diseases, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Carrer Jacint Verdaguer, 90, 08906, Barcelona, Spain. orlando.garcia@sanitatintegral.org.
authors.forename: Orlando
authors.identifier: 0000-0002-9202-7272
authors.initials: O
authors.lastname: García-Bosch
authors.affiliation: Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Carrer Villarroel, 170, 08036, Barcelona, Spain.|Department of Digestive Diseases, Hospital Mútua de Terrassa, Plaça Doctor Robert, 5, 08221, Terrassa, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Aceituno
authors.affiliation: Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Carrer Villarroel, 170, 08036, Barcelona, Spain.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Ordás
authors.affiliation: Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Carrer Villarroel, 170, 08036, Barcelona, Spain.
authors.forename: Josefina
authors.initials: J
authors.lastname: Etchevers
authors.affiliation: Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Carrer Villarroel, 170, 08036, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Sans
authors.affiliation: Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Carrer Villarroel, 170, 08036, Barcelona, Spain.
authors.forename: Faust
authors.initials: F
authors.lastname: Feu
authors.affiliation: Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Carrer Villarroel, 170, 08036, Barcelona, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: Panés
authors.affiliation: Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Carrer Villarroel, 170, 08036, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Ricart
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents; D000069285:Infliximab
keywords: Infliximab; Observational study; Treatment outcome; Ulcerative colitis