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Predictors of early response to infliximab in patients with ulcerative colitis

Ferrante, Marc MD1*; Vermeire, Séverine MD, PhD1; Katsanos, Konstantinos H. MD, PhD1; Noman, Maja MD1; Van Assche, Gert MD, PhD1; Schnitzler, Fabian MD1; Arijs, Ingrid MSc1; De Hertogh, Gert MD2; Hoffman, Ilse MD, PhD3; Geboes, Karel MD, PhD2; Rutgeerts, Paul MD, PhD1

doi: 10.1002/ibd.20054
Original Clinical Articles: Predictors of Early Response to Infliximab in Patients With Ulcerative Colitis: Original Article

Background: Our objective is to report the outcome of infliximab (IFX) in ulcerative colitis (UC) patients from a single center and to identify predictors of early clinical response.

Methods: The first 100 UC patients (45 female; median age, 37.9 years) who received IFX at a single center were included. Eighty‐four patients received 5 mg/kg IFX, and 37 patients received a 3‐dose IFX induction at weeks 0, 2, and 6. The Mayo endoscopic subscore, assessed by sigmoidoscopy before inclusion, was 1, 2, and 3 in 5%, 52%, and 43% of patients, respectively. Sixty percent had pancolitis, 63% were on concomitant immunosuppressive therapy, 9% were active smokers, 64% had C‐reactive protein ≥5 mg/dL, and 44% were pANCA+/ASCA−. Five patients received IFX because of severe acute colitis refractory to intravenous corticosteroids.

Results: Early complete and partial clinical responses were observed in 41% and 24% of patients. Patients with early clinical response were significantly younger than nonresponders (median age, 35.7 versus 41.6 years, P = 0.041). Patients who were pANCA+/ASCA− had a significantly lower early clinical response (55% versus 76%; odds ratio [OR] = 0.40 (0.16–0.99), P = 0.049). Concomitant immunosuppressive therapy and the use of an IFX induction scheme did not influence early clinical response. Only 1 of 5 patients who received IFX for acute steroid‐refractory colitis required colectomy within 2 months.

Conclusions: IFX is an efficient therapy in UC, as shown by 65% early clinical response. A pANCA+/ASCA− serotype and an older age at first IFX infusion are associated with a suboptimal early clinical response.

(Inflamm Bowel Dis 2006)

1Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium

2Department of Pathology, University Hospital Gasthuisberg, Leuven, Belgium

3Department of Pediatric Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium

*Department of Gastroenterology, University Hospital Gasthuisberg

E‐mail: marcferrante@yahoo.com

Received for publication 1 August 2006; Accepted 7 August 2006

Published online 19 December 2006 in Wiley InterScience (www.interscience.wiley.com).

© Crohn's & Colitis Foundation of America, Inc.
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