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  • Title: Infliximab dependency is related to decreased surgical rates in adult Crohn's disease patients.
    Author: Pedersen N, Duricova D, Lenicek M, Elkjaer M, Bortlik M, Andersen PS, Vitek L, Davidsen B, Wewer V, Lukas M, Munkholm P.
    Journal: Eur J Gastroenterol Hepatol; 2010 Oct; 22(10):1196-203. PubMed ID: 20739896.
    Abstract:
    BACKGROUND: Infliximab dependency in children with Crohn's disease (CD) has recently been described and found to be associated with a decreased surgery rate. AIM: To assess infliximab dependency of adult CD patients, evaluate the impact on surgery, and search for possible clinical and genetic predictors. METHODS: Two hundred and forty-five CD patients treated with infliximab were included from Danish and Czech Crohn Colitis Database (1999-2006). Infliximab response was assessed as immediate outcome, 1 month after infliximab start: complete, partial, and no response. Three months outcome, after last intended infusion: prolonged response (maintenance of complete/partial response), infliximab dependency (relapse requiring repeated infusions to regain complete/partial response or need of infliximab >12 months to sustain response). RESULTS: Forty-seven percent obtained prolonged response, 29% were infliximab dependent and 24% nonresponders. The cumulative probability of surgery 40 months after infliximab start was 20% in prolonged responders, 23% in infliximab-dependent patients and 76% in nonresponders (P<0.001). The cumulative probability of surgery at 40 months in patients on maintenance versus on demand regime was 33 and 31%, respectively (P=0.63). No relevant clinical or genetic predictors were identified. CONCLUSION: The infliximab dependency response seems to be equivalent to the prolonged response in adult CD patients when comparing surgery rates.
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