Clinical Research
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2007; 13(39): 5238-5244
Published online Oct 21, 2007. doi: 10.3748/wjg.v13.i39.5238
Maintenance of remission with infliximab in inflammatory bowel disease: Efficacy and safety long-term follow-up
Renato Caviglia, Mentore Ribolsi, Marina Rizzi, Sara Emerenziani, Maria Laura Annunziata, Michele Cicala
Renato Caviglia, Mentore Ribolsi, Marina Rizzi, Sara Emerenziani, Maria Laura Annunziata, Michele Cicala, Department of Digestive Diseases, Campus Bio-Medico University, Rome, Italy
Author contributions: All authors contributed equally to the work.
Correspondence to: Renato Caviglia, MD, PhD, University Campus Bio-Medico, Department of Digestive Disease, Via E. Longoni, Rome 8300155, Italy.
Telephone: +39-62-2541560 Fax: +39-62-2541520
Received: May 15, 2007
Revised: August 8, 2007
Accepted: September 24, 2007
Published online: October 21, 2007

AIM: To evaluate the safety and efficacy of a long-term therapy with infliximab in Crohn’s disease (CD) and ulcerative colitis (UC) patients retrospectively.

METHODS: The medical charts of 50 patients (40 CD and 10 UC), who received after a loading dose of 3 infliximab infusions scheduled re-treatments every 8 wk as a maintenance protocol, were reviewed.

RESULTS: Median (range) duration of treatment was 27 (4-64) mo in CD patients and 24.5 (6-46) mo in UC patients. Overall, 32 (80%) CD and 9 (90%) UC patients showed a sustained clinical response or remission throughout the maintenance period. Three CD patients shortened the interval between infusions. Eight (20%) CD patients and 1 UC patient underwent surgery for flare up of disease. Nine out of 29 CD and 4 out of 9 UC patients, who discontinued infliximab scheduled treatment, are still relapse-free after a median of 16 (5-30) and 6.5 (4-16) mo following the last infusion, respectively. Ten CD patients (25%) and 1 UC patient required concomitant steroid therapy during maintenance period, compared to 30 (75%) and 9 (90%) patients at enrolment. Of the 50 patients, 16 (32%) experienced at least 1 adverse event and 3 patients (6%) were diagnosed with cancer during maintenance treatment.

CONCLUSION: Scheduled infliximab strategy is effective in maintaining long-term clinical remission both in CD and UC and determines a marked steroid sparing effect. Long-lasting remission was observed following infliximab withdrawal.

Keywords: Inflammatory bowel disease, Crohn’s disease, Ulcerative colitis, Infliximab therapy, Steroid sparing