title: [Long-term infliximab therapy for ulcerative colitis in real clinical practice].
abstract: OBJECTIVE
  to retrospectively evaluate the efficiency of long-term infliximab (INF) therapy in patients with refractory ulcerative colitis (UC).
  
  
  METHODS
  The investigation enrolled 48 patients with refractory UC who had taken IFL in 2008 to 2014. Steroid-dependent or steroid-refractory UC was established in 40 (83.3%) patients; 8 (16.7%) were noted to be refractory to therapy with azathioprine or 6-mercaptopurine. Cytomegalovirus DNA was identified in the biopsy specimens of the large intestinal mucosa (LIM) from 7 patients. One patient received antiviral therapy. Induction therapy with IFL was in its administration in a dose of 5 mg/kg at 0, 2, and 6 weeks, then maintenance therapy was continued every 8 weeks.
  
  
  RESULTS
  After an IFL induction cycle, 3 (6.3%) patients were unresponsive to therapy and were excluded from the investigation. At present, 25 (55.5%) of the 45 patients who have responded to the therapy continue to take IFL 5 mg/kg every 8 weeks and are in clinical remission; 4 (8.8%) patients receive intensified IFL therapy. Initially 23 patients received combined therapy with IFL + an immunosuppressive drug; 22 had IFL monotherapy. Escape from the effect of the performed therapy was observed in 5 (11.1%) patients, which required its intensification. The intensified therapy resulted in sustained remission in 4 (8.8%) patients; colectomy was carried out in one (2.2%) case. Secondary loss of response to IFL, its intolerance, development of severe infectious complications, which did not allow for further maintenance therapy with IFL, were seen in 11 (24.4%) patients; 5 (11.1%) stopped the therapy because they had been excluded from the additional drug subsidy list. Maintenance therapy with IFL proved successful during 64 months in 29 (64.4%) of the 45 patients and during 64 months if its intensity, when the occasion required, was enhanced.
  
  
  CONCLUSIONS
  The long-term use of IFL in UC confirmed its high efficacy in achieving clinical response, in inducing a clinical remission and its capacity to heal LIM, and in sustaining remission.
authors.affiliation: Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia.
authors.forename: O V
authors.initials: OV
authors.lastname: Knyazev
authors.affiliation: Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia.
authors.forename: A I
authors.initials: AI
authors.lastname: Parfenov
authors.affiliation: Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia.
authors.forename: A V
authors.initials: AV
authors.lastname: Kagramanova
authors.affiliation: Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia.
authors.forename: I N
authors.initials: IN
authors.lastname: Ruchkina
authors.affiliation: Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia.
authors.forename: P L
authors.initials: PL
authors.lastname: Shcherbakov
authors.affiliation: N.N. Blokhin Russian Cancer Research Center, Moscow, Russia.
authors.forename: N K
authors.initials: NK
authors.lastname: Shakhpazyan
authors.affiliation: Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia.
authors.forename: K K
authors.initials: KK
authors.lastname: Noskova
authors.affiliation: Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia.
authors.forename: T I
authors.initials: TI
authors.lastname: Ivkina
authors.affiliation: Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia.
authors.forename: S G
authors.initials: SG
authors.lastname: Khomeriki
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D000069285:Infliximab / Q000008:administration & dosage / Q000009:adverse effects; D000069451:Long Term Adverse Effects / Q000453:epidemiology / Q000209:etiology; D008297:Male; D054539:Medication Therapy Management / Q000706:statistics & numerical data; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D062072:Patient Acuity; D012189:Retrospective Studies; D012426:Russia / Q000453:epidemiology; D063189:Symptom Assessment / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents; D000069285:Infliximab