Mo1324 Association of a Panel of Anti-Microbial Antibodies With Disease Behavior and Response to Anti-TNF Therapy in a Cohort of Patients With Ulcerative Colitis

Abstract

Infliximab is highly efficacious in induction as well as maintenance of remission in patients with Crohn's disease (CD). However, the cost and potential serious side-effects is concerning for continuing the medication on a long-term. Primary aim of this meta-analysis was to determine the outcome in patients with CD in whom infliximab was discontinued while in remission. Secondary aim was to assess the results of re-treatment with anti-TNF agents following a relapse and identify the factors associated with a relapse. MethodsWe searched Medline, Scopus, conference proceedings and Google scholar for Infliximab related trials in Crohn's disease. Studies where the information on status of remission prior to discontinuation of infliximab was unclear or the clinical outcome following the discontinuation of infliximab was unavailable were excluded. For studies which provided complete data over at least 3 years, the median remission rate was calculated using Kaplan-Meier method. For studies which provided median remission rate, an average of the remission rates was calculated. ResultsA total of 398 patients in six different studies were included in the final analysis. The average relapse rates over 1st, 2nd, 3rd, 4th and 6th year following the cessation of infliximab were 35%, 48%, 62%, 69% and 76% respectively. The results of Kaplan-Meier analysis for the 4 studies (219 patients) with detailed data over at least 3 years data are given in Table-1. Following relapse, retreatment with infliximab results in remission in 91100% (89 patients). Medication reaction following retreatment with infliximab occurred in only one patient. ConclusionMajority of patients who discontinue infliximab while in remission will relapse and most relapses will occur in first 3 years following cessation of infliximab. Retreatment with infliximab is however favorable and risk of re-treatment reaction is not increased. Kaplan Meier Statistics