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Mucosal healing influences outcomes in ulcerative colitis treated with infliximab

Impact of mucosal healing on long-term outcomes in ulcerative colitis treated with infliximab, reports this month's Alimentary Pharmacology & Therapeutics.

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Dr Laharie and colleagues assessed the impact of mucosal healing on long-term outcomes in patients with ulcerative colitis (UC) when treated with infliximab (IFX) beyond 1 year.

All consecutive adult patients with refractory ulcerative colitis receiving maintenance treatment with infliximab in 5 French referral centres were analyzed retrospectively.

The team included only patients who had endoscopic evaluation between 6 and 52 weeks following infliximab initiation.

According to their Mayo endoscopic sub-score, patients were categorized into mucosal healing and no mucosal healing.

The team of researchers' outcome measures included colectomy, and infliximab failure defined by drug withdrawal due to secondary failure among primary responders.

Of the 63 patients, 30 achieved mucosal healing.

Colectomy-free survival rates at 12 months was 100% with mucosal healing
Alimentary Pharmacology & Therapeutics

The median follow-up duration was 27 months.

The doctors found that 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.

The researchers noted that mucosal healing was the only factor associated with colectomy-free survival, with an odds ratio of 18.

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."

Aliment Pharmacol Ther 2013: (37)10: 998-1004
06 May 2013

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