title: Long-term outcome of infliximab treatment in chronic active ulcerative colitis: a Swedish multicentre study of 250 patients.
abstract: BACKGROUND
  Real-life long-term data on infliximab treatment in ulcerative colitis are limited.
  
  
  OBJECTIVE
  To study the long-term efficacy and safety of infliximab in chronic active ulcerative colitis and possible predictors of colectomy and response were also examined.
  
  
  METHODS
  A retrospective multi-centre study of infliximab treatment in 250 patients with chronic active ulcerative colitis with inclusion criteria: age ≥18 years, ambulatory treated, steroid-dependent or intolerant and/or immunomodulator refractory or intolerant.
  
  
  RESULTS
  Steroid-free clinical remission was achieved by 123/250 patients (49.2%) at 12 months and in 126/250 patients at a median follow-up of 2.9 years (50.4%). Primary response at 3 months was achieved by 190/250 (76.0%) patients and associated with a high probability of response 168/190 (88.4%) at 12 months and 143/190 (75.3%) at follow-up. Long-term rate of colectomy in primary responders was 6/190 (3.2%) at 12 months and 27/190 (14.2%) at last follow-up. Failure to achieve response at 3 months was associated with a high risk of subsequent colectomy, 29/60 (48.3%) at 12 months and 41/60 (68.3%) at follow-up. Response at 12 months was associated with a low risk of subsequent colectomy, 14/181 (7.7%) compared with non-response 19/34 (55.9%) (P < 0.0001). Non-response at 3 months was an independent predictor of subsequent colectomy (HR = 9.40, 95% CI = 5.10-17.35, P < 0.001). Concomitant azathioprine therapy did not influence outcome in terms of colectomy.
  
  
  CONCLUSIONS
  Long-term efficacy of infliximab treatment in chronic active ulcerative colitis is excellent especially in patients who respond to induction treatment. Conversely, non-response at 3 months predicts a poor outcome, with a high risk of subsequent colectomy.
authors.affiliation: Helsingborg, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Angelison
authors.affiliation: Stockholm, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Almer
authors.affiliation: Gothenburg, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Eriksson
authors.affiliation: Umeå, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Karling
authors.affiliation: Västerås, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Fagerberg
authors.affiliation: Örebro, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Halfvarson
authors.affiliation: Uppsala, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Thörn
authors.affiliation: Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Björk
authors.affiliation: Lund, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Hindorf
authors.affiliation: Stockholm, Sweden.
authors.forename: R
authors.initials: R
authors.lastname: Löfberg
authors.affiliation: Gothenburg, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Bajor
authors.affiliation: Linköping, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Hjortswang
authors.affiliation: Ängelholm, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Hammarlund
authors.affiliation: Malmö, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Grip
authors.affiliation: Kristianstad, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Torp
authors.affiliation: Lund, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Marsal
authors.affiliation: Lund, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Hertervig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D003082:Colectomy / Q000639:trends; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D013256:Steroids; D000069285:Infliximab; D001379:Azathioprine