LONG-TERM OUTCOME OF TREATMENT WITH INFLIXIMAB IN 440 CROHN'S DISEASE PATIENTS: RESULTS FROM A SINGLE CENTER COHORT

Infliximab reintroduction is not associated to a higher rate of immune-related adverse effects in patients with inflammatory bowel disease initially treated with a three-infusion induction regimen

BACKGROUND

Episodic infliximab (IFX) treatment is associated with a higher risk for acute infusion reactions (AIR) and secondary loss of response (SLR), but this has not been evaluated in patients initially treated with an induction regimen with 3 IFX infusions.

AIMS

To evaluate whether IFX reintroduction after > or = 4 months in patients treated with a 3-infusion induction regimen is associated with a higher incidence of AIR or SLR.

METHODS

Incidence of immunogenic adverse effects was assessed in patients with inflammatory bowel disease who received > or = 4 consecutive IFX infusions (3 infusions at weeks 0, 2, and 6, plus > or = 1 maintenance infusion) (Continuous, n=47) and patients who were treated with a successful initial 3-infusion induction scheme and in whom IFX was then discontinued because of a complete response but reintroduced > or = 4 months later (Reintro, n=29).

RESULTS

AIR rate was 17% in both groups, and SLR rate was 26% in the Continuous group and 15% in the Reintro group (not significant). The lack of concomitant immunomodulators and/or pretreatment with hydrocortisone were associated with AIR development (P=0.002).

CONCLUSIONS

In patients who completed a 3-infusion induction regimen, IFX can be safely reintroduced even after a long time from discontinuation.

Inflammatory bowel diseases: meeting of the European Crohn’s Colitis Organization

Inflammatory bowel diseases affect > 1 million Europeans, and mostly people at a young age. Although these diseases are still increasing worldwide, especially in children and adolescents, progress in the pathophysiology and treatment of these diseases in recent years has been tremendous. In particular, anti-TNF-alpha agents dramatically changed the management of these diseases. The European Crohn's Colitis Organization recently held its second annual meeting in Innsbruck, Austria dealing with both new basic and clinical developments in the field.