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Treatment of crohns disease by infliximab long term efficiency in 137 patients treated during the year 2000



Treatment of crohns disease by infliximab long term efficiency in 137 patients treated during the year 2000



Digestive Disease Week Abstracts & Itinerary Planner : Abstract No T1380



Several studies demonstrated the efficiency of Infliximab in Crohn's disease (CD), but long term evolution after treatment remains poorly evaluated. AIM: To evaluate the long term efficiency of Infliximab in CD patients treated during the year 2000. METHODS: 147 CD patients treated with at least 1 infusion of Infliximab in one of the GI units of public Parisian hospitals (AP-HP, Paris, France, 12 centers) between 01/01/00 and 12/31/00 were retrospectively analysed. RESULTS (mean +/- SD) : 137 CD patients (36.0 +/- 12.7 yrs, 92 women) have been included, 10 patients were excluded because of the lack of follow-up information. The indication of the treatment was fistulae or perianal disease (F) in 39%, active disease (A) in 45% and a mixed condition (F + A = M) in 16%. CD was diagnosed 10.0 +/- 7.4 yrs before 1st infusion. Previous treatments included steroids in 91%, immunosuppressive (IS) in 80% and 66% had previous surgery (2,6 intervention/patient). At the time of the 1st infusion, 16% of the patients had no treatment, 4% were treated with only 5-ASA, 58% with steroids (48 steroid-dependent, mean daily prednisone intake : 28.0 +/- 15.7 mg/d; 31 steroid-resistant patients) and 50% with IS. The number of infusions (5mg/kg) was 3.6 +/- 2.4 by patient (range: 1-11). The mean follow-up was 15.2 +/- 7.2 months. Responses rates at 3, 6, 9, 12 and 18 months are shown on table. Median time of relapse was 6.1 +/- 0.9 months. Univariate analysis demonstrated that indications (A, F or M), time elapsed since diagnosis, smoking status and IS at the time of 1st injection were not predictive factors of the response to infliximab. A durable steroid weaning was obtained in 82% of the patients. 73 patients had to be retreated with at least 1 infusion and 39 were treated by repeated infusions. An adverse event was noted in 32% of the patients (11 early AE, 17 late AE including 1 tuberculosis, no lymphoma). CONCLUSION On the short term, Infliximab is efficient and safe in CD patients ; but on the long term, results are less relevant. No predictive factors of efficiency could be evidenced. Long term steroid weaning could be one of its major interest.

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Accession: 035981510

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DOI: 10.1016/S0016-5085(03)82641-0



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