The Long-term Outcome Of Treatment With Infliximab In Crohn’s Disease In China From A Single Referral Center

Background and aids:Due to the responses to Infliximab(IFX)differ in Crohn’s disease(CD)patients,the efficacy and safety are on the focus.We aim to assess the efficacy and safety of IFX in our center.Materials and methods:We reviewed the digital records of inflammatory bowel disease patients treated with IFX in our center to collect the clinical and demographic data.The primary endpoints was sustained response,while relapse after discontinuation of IFX and adverse effects were secondary endpoints.Survival analysis and multivariable Cox model were used to analyze the data.Results:486 patients reaching the inclusion criterions were included with the median follow-up length of 28.92 months(IQR 12.00-40.00months).There were 444 patients(91.36%)in maintenance therapy and 369 patients(75.93%)in sustained response.The estimated sustained response rate at 4.5 years was 58.74%,which concurrent treatment with immunomodulators made for while an older age(≥40 years)at diagnosis and higher platelet counts at the baseline went against.We included 159 patients who discontinued IFX on a remission to evaluate the relapse.Of them,79 patients(49.68%)had a relapse with the median time of 19.04 months(IQR 9.00-27.00 months).The estimated relapse rate after two-year discontinuation of IFX was 48.29%,which was in correlation with a younger age at diagnosis(<17 years).Adverse effects occurred to 94 patients(19.34%)during the treatment of IFX.There were forty-one patients with acute infusion reaction,there(0.62%)with infection of tuberculosis and one(0.21%)with colon cancer after 22-month discontinuation of IFX.Conclusions:Long-term treatment with IFX is efficacious and safe to CD patients in China.Combination therapy with immunomodulators can improve the sustained response.Physicians should pay attention to adverse effects during the treatment,especially to acute infusion reactions and intensify the follow-wp with the patients,in particular the young,who have discontinued IFX since one to two years ago.