Long-term clinical outcome after infliximab discontinuation in patients with inflammatory bowel disease
- Authors
- Lee, Ji Min; Kim, Yoon Jae; Lee, Kang-Moon; Yoon, Hyuk; Lee, Bo-In; Kim, Dae Bum; Kang, Donghoon
- Issue Date
- 2-Nov-2018
- Publisher
- TAYLOR & FRANCIS LTD
- Keywords
- Infliximab; discontinuation; inflammatory bowel disease; relapse
- Citation
- SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, v.53, no.10-11, pp.1280 - 1285
- Journal Title
- SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY
- Volume
- 53
- Number
- 10-11
- Start Page
- 1280
- End Page
- 1285
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/3078
- DOI
- 10.1080/00365521.2018.1524024
- ISSN
- 0036-5521
- Abstract
- Objectives: We investigated the long-term clinical outcome and risk factors for clinical relapse in inflammatory bowel disease (IBD) patients after stopping infliximab (IFX). Materials and methods: We retrospectively reviewed the medical records of IBD patients who were treated with IFX in four university hospitals in South Korea. Among them, patients who discontinued scheduled IFX therapy with a favorable disease course were enrolled. Clinical relapse was defined as an increase in disease activity, addition of new drugs, or abdominal surgery. Results: In total, 28 ulcerative colitis (UC) patients and 17 Crohn's disease (CD) patients were enrolled. The median duration of follow-up after discontinuation was 41 months (range: 8-109 months) in UC patients and 141 months (range: 66-262 months) in CD patients. The cumulative probability of relapse at 12 months was 32.1% in UC patients and 30.7% in CD patients. Fewer IFX infusions and a shorter duration of mesalamine treatment after IFX discontinuation were risk factors for relapse after IFX discontinuation in UC patients (p = .04 and .01, respectively). In CD patients, a higher erythrocyte sedimentation rate and CRP at IFX discontinuation and a shorter duration of azathioprine treatment after IFX discontinuation were risk factors for relapse (p = .03, .03 and .01, respectively). Conclusions: Approximately 30% of IBD patients who responded to IFX therapy experienced relapse within 1 year after discontinuation. We identified several risk factors for relapse. Further studies should identify factors predictive of the disease course after discontinuing IFX maintenance therapy.
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