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 > or =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.