Mucosal healing can be achieved with infliximab.
Dr Laharie and colleagues from France assessed the impact of mucosal healing on long-term outcomes in patients with ulcerative colitis when treated with infliximab beyond 1 year.
All consecutive adult patients with refractory ulcerative colitis receiving maintenance treatment with infliximab in 5 French referral centres were analyzed retrospectively.
Only patients who had endoscopic evaluation between 6 and 52 weeks following infliximab initiation were included.
According to their Mayo endoscopic sub-score, patients were categorized into mucosal healing, and no mucosal healing.
|48% achieved mucosal healing|
|Alimentary Pharmacology & Therapeutics|
Outcome measures were colectomy and infliximab failure defined by drug withdrawal due to secondary failure among primary responders.
Of the 63 patients, 48% achieved mucosal healing.
The median follow-up duration was 27 months.
Colectomy-free survival rates at 12, 24 and 36 months were, respectively, 100%, 96% and 96% in patients with mucosal healing.
The corresponding figures were, respectively, 80%, 65% and 65% in patients without mucosal healing.
By multivariate analysis, mucosal healing was the only factor associated with colectomy-free survival, with an odds ratio of 18.
The team noted that infliximab failure-free survival rates at 12, 24 and 36 months were, respectively, 76%, 69% and 64% in patients with mucosal healing, and 44%, 25% and 21% in those without mucosal healing.
Dr Laharie's team commented, "Patients with refractory ulcerative colitis who achieved mucosal healing after infliximab initiation had better long-term outcomes, with significantly less colectomy and less infliximab failure."