Mucosal healing did not predict sustained clinical remission in patients with IBD after discontinuation of one-year infliximab therapy

• Published in: PloS one 2014-10, Vol.9 (10), p.e110797-e110797
• Main Authors: Dai, Cong, Liu, Wei-Xin, Jiang, Min, Sun, Ming-Jun
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Antibodies, Monoclonal - administration & dosage; Biology and Life Sciences; Colitis, Ulcerative - drug therapy; Colitis, Ulcerative - physiopathology; Consent; Crohn Disease - drug therapy; Crohn Disease - physiopathology; Crohn's disease; Endoscopy; Ethics; Female; Gastroenterology; Healing; Humans; Immunotherapy; Inflammatory bowel disease; Inflammatory bowel diseases; Infliximab; Intestinal Mucosa - physiology; Intestine; Male; Medical research; Medicine and Health Sciences; Middle Aged; Monoclonal antibodies; Mucosa; Patients; Regeneration - drug effects; Remission; Remission (Medicine); Remission Induction; Restarting; Surgery; Therapy; Tumor necrosis factor-TNF; Tumor necrosis factor-α; Ulcerative colitis
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0110797

To assess the endoscopic activity and Clinical activity after a one-year period of infliximab therapy and to evaluate the association between mucosal healing and need for retreatment after stopping infliximab in patients with Inflammatory bowel disease (IBD). The data from 109 patients with Crohn's disease (CD) and 107 patients with Ulcerative colitis (UC) received one-year infliximab were assessed. The primary endpoint of the study was the proportion of clinical remission, mucosal healing and full remission in IBD after the one-year period of maintenance infliximab therapy. The secondary endpoint was the frequency of relapses in the next year. A total of 84.4% (92/109) CD patients and 81.3% (87/107) UC patients achieved clinical remission, 71.56% (78/109) of CD patients and 69.16% (74/107) of UC patients achieved mucosal healing, 56.88% (62/109) of CD patients and 54.21% (58/107) of UC patients achieved full remission at the end of the year of infliximab therapy. Infliximab therapy was restarted in the 10.19% (22/216) patients (13 CD, 9 UC) who achieved mucosal healing, and 13.89% (30/216) patients (18 CD, 12 UC) who achieved clinical remission and 6.48% (14/216) patients (8 CD, 6 UC) who achieved full remission had to be retreated within the next year. Neither clinical remission nor mucosal healing was associated with the time to restarting Infliximab therapy in IBD. Mucosal healing did not predict sustained clinical remission in patients with IBD in whom the infliximab therapies had been stopped. And stopping or continuing infliximab therapy may be determined by assessing the IBD patient's general condition and the clinical activity.