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BACKGROUND: Infliximab has been shown to be of benefit in the treatment of ulcerative colitis but long-term colectomy rates remain unknown. AIMS: To review the rate of colectomy after infliximab for ulcerative colitis and to identify factors that might predict the need for colectomy. METHODS: We conducted a retrospective cohort study of patients with active ulcerative colitis treated with infliximab between 2000 and 2006. The primary outcome was colectomy-free survival. Disease and treatment characteristics and complications were documented. RESULTS: Thirty patients were treated with infliximab for refractory ulcerative colitis. Sixteen (53%) came to colectomy a median of 140 days after their first infusion (range 4-607). There was no difference in colectomy between those receiving infliximab for acute severe ulcerative colitis failing intravenous steroids (8/14) and out-patients with steroid-refractory ulcerative colitis (8/16). Only 17% (5/30) achieved a steroid-free remission after a median follow-up of 13 months (range 2-72). Univariate analysis showed that a younger age at diagnosis of colitis was significantly associated with an increased rate of colectomy (27.5 years vs. 38.7 years, P = 0.016). CONCLUSION: Over half the patients studied came to colectomy. Of those avoiding colectomy, only five (17%) sustained a steroid-free remission.

Original publication

DOI

10.1111/j.1365-2036.2007.03300.x

Type

Journal article

Journal

Aliment Pharmacol Ther

Publication Date

01/05/2007

Volume

25

Pages

1055 - 1060

Keywords

Antibodies, Monoclonal, Cohort Studies, Colectomy, Colitis, Ulcerative, Disease-Free Survival, Female, Gastrointestinal Agents, Humans, Infliximab, Male, Middle Aged, Retrospective Studies, Treatment Outcome