Inflammatory Bowel Diseases

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

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

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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)

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

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