Efficacy Of Infliximab In Patients Research Articles

Focusing on non-responders to infliximab with ulcerative colitis, what can we do first and next?

BackgroundUlcerative colitis (UC) is a chronic immune-mediated inflammation of the colorectum, for which infliximab (IFX) is currently the mainstay of treatment. However, one-third of patients with UC still fail to benefit from the IFX therapy, and early exposure to IFX impairs the efficacy of other subsequent biologics. Therefore, personalized therapeutic system is urgently needed to assist in clinical decision-making and precision treatment. MethodsFour microarray datasets of colonic biopsies from UC patients treated with IFX were obtained from the GEO database to form the Training Cohort and Validation Cohort. Differentially expressed genes (DEGs) in Training Cohort were identified and enriched for GO, KEGG and immune cell infiltration analysis. A prediction model for IFX efficacy was developed based on the LASSO and Logistic regression. The predictive accuracy of the model was verified by the Validation Cohort, and the model-genes/proteins were validated by immunohistochemistry. Gene-drug, gene-ncRNA interaction analysis were performed to identify drugs or non-coding RNAs (ncRNAs) that potentially interacted with the model-genes. Homology Modeling and Molecular Docking were conducted to filter the optimal candidate as the subsequent adjuvant or alternative for IFX in predicted non-responders. At last, the down-regulation of the key model-gene/protein CYP24A1 by the drug candidate Deferasirox was verified by Western Blot and qRT-PCR Assay based on cellular experiments. ResultsA total of 113 DEGs were identified in the Training Cohort, mainly enriched in inflammatory cell chemotaxis, migration, and response to molecules derived from intestinal microbiota. Activated pro-inflammatory innate immune cells, including neutrophils, M1 macrophages, activated dendritic cells and mast cells, were significantly enriched in colons of non-responders. The prediction model based on three model-genes (IFI44L, CYP24A1, and RGS1) exhibited strong predictive efficacy, with AUC values of 0.901 and 0.80 in the Training and Validation Cohorts, respectively. Higher expression of the three model-genes/proteins in colons of non-responders to IFX was confirmed by clinical colonic mucosal biopsies. 4 Drugs (Calcitriol, Lunacalcipol, Deferasirox, Telaprevir), 15 miRNAs and 66 corresponding lnRNAs interacting with model-genes were identified. The protein 3D structure of the key model-gene/protein (human-derived CYP24A1) was developed. Through the Molecular Docking and cellular experimental validation, Deferasirox, which significantly down-regulated both the RNA and protein expression of CYP24A1, was identified as the optimal adjuvant or alternative for IFX in predicted non-responders with UC. ConclusionThis study developed a novel prediction model for pre-assessing the efficacy of IFX in patients with UC, as the first step towards personalized therapy. Meanwhile, drugs and non-coding RNAs were provided as potential candidates to develop the next-step precise treatment for the predicted non-responders. In particular, Defeasirox appears to hold promise as an adjuvant or alternative to IFX for the optimization of UC therapy.

Prognostic factors for the efficacy of infliximab in patients with luminal fistulizing Crohn’s disease

BackgroundEnteric fistula is one of the penetrating features in Crohn’s disease (CD). This study aimed to clarify the prognostic factors for the efficacy of infliximab (IFX) treatment in luminal fistulizing CD patients.MethodsWe retrospectively included 26 cases diagnosed with luminal fistulizing CD hospitalized in our medical center from 2013 to 2021. The primary outcome of our research was defined as death from all causes and undergoing of any relevant abdominal surgery. Kaplan–Meier survival curves were used to describe overall survival. Univariate and multivariate analyses were used to identify prognostic factors. A predictive model was constructed using Cox proportional hazard model.ResultsThe median follow-up time was 17.5 months (range 6–124 months). The 1- and 2-year surgery-free survival rates were 68.1% and 63.2%, respectively. In the univariate analysis, the efficacy of IFX treatment at 6 months after initiation (P < 0.001, HR 0.23, 95% CI 0.01–0.72) and the existence of complex fistula (P = 0.047, HR 4.11, 95% CI 1.01–16.71) was found significantly related to the overall surgery-free survival, while disease activity at baseline (P = 0.099) also showed predictive potential. The multivariate analysis showed that efficacy at 6 months (P = 0.010) was an independent prognostic factor. The C-index of the model for surgery-free survival was 0.923 (P < 0.001), indicating an acceptable predictive effect.ConclusionPrognostic model including the existence of complex fistula, disease activity at baseline and efficacy of IFX at 6 months may be useful to predict long-term outcome of luminal fistulizing CD patients.

Effects of visceral adipose tissue on anti-tumour necrosis factor-α in Crohn's disease.

It remains unclear whether visceral adipose tissue (VAT) can predict the response of patients with Crohn's disease (CD) to anti-tumour necrosis factor-α (anti-TNF-α) therapy. This study aimed to investigate whether VAT predicts the efficacy of infliximab (IFX) for different sites of CD and its relationship with serum TNF-α levels and IFX serum trough concentration. This is a multicentre retrospective study. Patients with CD treated with IFX from January 2014 to January 2021 were included. The perimeter of the visceral adipose area was obtained by a Computed Tomography (CT) scan. Participants were classified according to the lesion site (L1, L2, and L3) and visceral fat area. The participants were divided into colon-uninvolved non-visceral obesity (L1-VATL), colon-uninvolved visceral obesity (L1-VATH), colon-involved non-visceral obesity (L2 + L3-VATL), and colon involved visceral obesity (L2 + L3-VATH) groups. The end points of this study were set as disease remission status at 6 and 12 months. The final cohort included 140 patients. Regarding efficacy at 6 and 12 months, there was a significant difference between L1-VATL (73.8% versus 36.8%, p = 0.006) and L1-VATH (81.0% versus 47.4%, p = 0.008) groups. In the analysis of serum TNF-α levels and IFX serum trough concentrations, there was a significant difference between L1-VATL and L1-VATH (59.5 pg/mL versus 236.0 pg/mL, pTNF-α = 0.006), (10.0 μg/mL versus 0.4 μg/mL, pIFX = 0.000), and L1-VATH and L2 + L3-VATH (78.7 pg/mL versus 118.6 pg/mL, pTNF-α = 0.031), (0.4 μg/mL versus 6.40 μg/mL, pIFX = 0.017). In L1 patients, the VAT level predicted the efficacy of IFX, with high VAT values indicating poor efficacy. The VAT level may be a useful radiological marker to predict the efficacy of IFX in patients with various types of CD.

Efficacy and Safety of Infliximab in Intestinal Behçet's Disease: A Multicenter, Phase 3 Study (BEGIN).

To date, there is no prospective study that specifically investigated the efficacy of infliximab in intestinal Behçet's disease (BD). This study evaluated the efficacy of infliximab in patients with moderate-to-severe active intestinal BD that are refractory to conventional therapies. This phase 3, interventional, open-label, single-arm study evaluated clinical outcomes of infliximab treatment in patients with moderate-to-severe intestinal BD. The coprimary endpoints were clinical response, decrease in disease activity index for intestinal BD (DAIBD) score ≥20 from weeks 0 to 8 for the induction therapy and week 32 for the maintenance therapy. A total of 33 patients entered the induction therapy and were treated with infliximab 5 mg/kg intravenously at weeks 0, 2, and 6. The mean DAIBD score changed from 90.8±40.1 at week 0 to 40.3±36.4 at week 8, with a significant mean change of 50.5±36.4 (95% confidence interval, 37.5 to 63.4; p<0.001). Thirty-one (93.9%) continued to receive 5 mg/kg infliximab every 8 weeks during the maintenance therapy. The mean change in the DAIBD score after the maintenance therapy was statistically significant (61.5±38.5; 95% confidence interval, 46.0 to 77.1; p<0.001, from weeks 0 to 32). The proportion of patients who maintained a clinical response was 92.3% at week 32. No severe adverse reactions occurred during the induction and maintenance therapies. This study provided evidence that infliximab 5 mg/kg induction and maintenance therapies are efficacious and well-tolerated in patients with moderate-to-severe active intestinal BD. (ClinicalTrials.gov identifier: NCT02505568).

Predictors of the efficacy of infliximab in patients with ulcerative colitis

Introduction. The currently known prognostic criteria for biological therapy have limitations and have not been widely used in clinical practice. Aim. Find predictors of the effectiveness of biological therapy with infliximab in patients with ulcerative colitis. Materials and methods. The object of the study was patients (n = 52) diagnosed with Ulcerative Colitis in the active form of the disease, including 27 men and 25 women undergoing therapy with infliximab. Follow-up was carried out for three years from the start of therapy. The age of the examined persons ranged from 19 to 64 years (mean age 34.76 ± 2.13 years). The mean score on the Mayo scale was 6.1 ± 3.49. Results. In the course of our study, we obtained the following data on the effectiveness of infliximab therapy in patients with severe ulcerative colitis: a significant improvement in the dynamics of laboratory and instrumental parameters was recorded in 25 people (43.8%); the onset of stable clinical remission — in 15 people (26.3%); disease progression — in 5 cases (8.7%); lack of dynamics or a less pronounced effect — in 12 cases (21.2%). Conclusions. We have identified a system of clinical and laboratory factors that make it possible to predict the effectiveness of biological therapy with infliximab in patients with ulcerative colitis. The mathematical model in the form of a discriminant function makes it possible to divide patients into groups depending on the possible effect of the use of biological therapy with infliximab before its initiation (the sensitivity of the model is 83.3%, the specificity is 71.4%).

Performance of Remsima® Monitor Drug Level versus RIDASCREEN IFX Monitoring in therapeutic drug monitoring of infliximab in patients with inflammatory bowel disease: A study of diagnostic accuracy.

Therapeutic drug monitoring (TDM) is effective in optimizing the efficacy of infliximab in patients with inflammatory bowel disease (IBD). An affordable way of monitoring is in high demand. This study evaluated the analytical and clinical performances of the newly available Remsima monitor kits and compared them with the established enzyme-linked immunosorbent assay kits. The trough level of infliximab in patients with IBD treated with an infliximab originator (Remicade) or biosimilar compounds (Remsima and Remaloce) was measured using a Remsima® Monitor Drug Level (Remsima) kit at the Samsung Medical Center, Seoul, Korea. Twenty-six plasma samples were collected immediately before the infusion of infliximab from 18 patients with IBD (Remicade, n = 8; Remsima, n = 6; and Remaloce, n = 4). The intra-assay intraclass correlation coefficient (ICC) of the RIDA and Remsima kits was 0.951 (95% CI = 0.908–0.976) and 0.990 (95% CI = 0.981–0.995). The inter-assay ICC of infliximab trough level between the RIDA and Remsima kits was very high (R = 0.971; 95% CI = 0.935–0.987), and the mean difference between the kits was 1.458 (95% limits of agreement = −3.302 to 6.219). The intra- and inter-assay reliabilities of all types of infliximab did not show significant differences. Qualitative stratification revealed substantial similarities between the kits (weighted kappa = 0.798). This study indicated that the Remsima kit was reproducible and highly correlated with the RIDA kit.

Clinical Efficacy of Infliximab in Patients With Crohn Disease in Different Locations of Disease Pathology: A Meta-Analysis

Infliximab (INX) has been approved for treating Crohn disease (CD) for many years, showing promis-ing efficacy in the clinic. However, the efficacy of the drug and the prognosis of CD vary significantly with dif-ferent locations of disease pathology. This study evaluated the efficacy of INX and prognosis in CD in different locations of disease pathology using systematic meta-analysis. We used "Infliximab OR Remicade OR Avakine OR Inflectra OR Renflexis OR Remsima OR IgG1k monoclonal antibody" AND "Crohn's disease OR IBD OR inflammatory bowel disease" as search strategies for searching in PubMed, Wanfang and Embase. A systematic meta-analysis for overall proportions was used to analyze the data. Twelve studies involving 1,978 patients were included. The results confirmed that treatment with INX led to high clinical remission rates (82%, 95% CI: 64%-92%) and low relapse rates (4%, 95% CI: 2%-9%) in patients with CD. Our results also indicated that use of INX in patients with colon only (L2) CD led to lower clinical remission rates, and use of INX in patients with ileum and colon (L3) CD led to higher relapse rates. Our findings show different remission rates depending on location of the disease and may be useful for clinicians' choice of therapeutics.

Treatment of corticosteroid refractory immune checkpoint inhibitor myocarditis with Infliximab: a case series

BackgroundGlucocorticoid treatment remains the cornerstone of therapy for immune checkpoint inhibitor (ICI) myocarditis, but data supporting the use of additional immunotherapy for steroid refractory cases remains limited. We investigate the safety and efficacy of infliximab in patients with ICI myocarditis who are refractory to corticosteroids. Additionally, we highlight the importance of a multi-disciplinary approach in the care for these complex patients.MethodsWe retrospectively identified consecutive patients who developed ICI myocarditis at our institution between January 2017 and January 2020. Baseline characteristics, laboratory data and clinical outcomes were compared between patients who received infliximab and those who did not.ResultsOf a total of 11 patients who developed ICI myocarditis, 4 were treated with infliximab. Aside from age, there were no significant differences in baseline patient characteristics between the two groups including total number of ICI doses received and duration from initial ICI dose to onset of symptoms. The time to troponin normalization was 58 vs. 151.5 days (p = 0.25). The duration of prednisone taper was longer in the infliximab group (90 vs. 150 days p = 0.32). All patients survived initial hospital admission. Over a median follow-up period of 287 days, two of the 4 patients died from sepsis 2 and 3 months after initial treatment of their myocarditis; one of these patients was on a steroid taper and the other patient had just completed a steroid taper.ConclusionsInfliximab, despite its black box warning in patients with heart failure, may be a safe and effective treatment for ICI myocarditis.

Therapeutic drug monitoring of infliximab in spondyloarthritis. A review of the literature

Available evidence indicates that a therapeutic drug monitoring strategy leads to major cost savings related to the anti-tumour necrosis factor-α therapy in both inflammatory bowel disease and rheumatoid arthritis (RA) patients, with no negative impact on efficacy. However, although the systematic use of therapeutic drug monitoring could potentially be beneficial and economically acceptable to drug dose optimization, it is not justifiable for all drugs. Infliximab (IFX) is a chimeric monoclonal immunoglobulin G1 targeting tumour necrosis factor. It has been approved for the treatment of immuno-inflammatory diseases, including RA, ankylosing spondylitis, psoriatic arthritis, Crohn's disease and ulcerative colitis. IFX's pharmacokinetics is highly variable and influences clinical response in chronic inflammatory diseases. Clinical response increases with IFX trough concentrations in RA, ankylosing spondylitis, inflammatory bowel disease and psoriatic patients. Target concentrations predictive of good clinical response were proposed in RA, Crohn's disease and ulcerative colitis. The purpose of this article is to review the current literature surrounding IFX serum concentrations and their related parameters with disease activity in patients with spondyloarthritis. Gathering information about the efficacy of IFX in patients with spondyloarthritis and relating IFX serum concentrations to disease activity were the main goals of this study.

A randomized, double-blind, placebo-controlled trial of infliximab in refractory polymyositis and dermatomyositis.

To investigate in a pilot study the safety and efficacy of infliximab in patients with refractory dermatomyositis (DM) and polymyositis (PM). A randomized, double-blind, placebo-controlled trial including subjects with active DM or PM. Participants had stable doses of immunosuppressive medication and prednisone (≤0.5mg/kg/day), and exhibited clinical signs of muscle weakness for at least 4 weeks prior to study entry. Participants received infusions of either placebo or infliximab 5mg/kg at 0, 2, 6, and 14 weeks in blinded manner. The primary outcome was a ≥15% manual muscle strength (MMT) improvement at week 16 compared to week 0. The secondary outcome measures were improvement defined by the International Myositis Assessment and Clinical Studies Group (IMACS) criteria. At week 16, responders in each arm had the option of either continuing the same treatment or changing to the non-responder treatment for that study arm. Non-responders in the 5mg/kg infliximab arm were increased to infliximab 7.5mg/kg for weeks 22, 30, and 38. Non-responders in the placebo arm at week 16 received infliximab 5mg/kg at weeks 16, 18, 22, 30, and 38. Outcomes were reassessed at week 40. Twelve subjects completed the study to week 16. Six of the 12 subjects received infliximab treatment at the dose of 5mg/kg with only one subject meeting the responder criteria at that dose. Of the remaining five subjects on infliximab, three crossed over to the infliximab 7.5mg/kg dose. One of those three subjects responded. All six patients in the placebo arm crossed over to the 5mg/kg dosing regimen after week 16, and two of those responded to infliximab. Infliximab therapy for patients with refractory PM and DM was well tolerated and may benefit a subset of patients.

Serum Interleukin 9 Levels Predict Disease Severity and the Clinical Efficacy of Infliximab in Patients with Crohn's Disease.

Interleukin (IL)-9 drives gut inflammation, but its role in Crohn's disease (CD) is unclear. We aimed to analyze correlations between serum IL-9 levels and disease severity and to evaluate their predictive value in relation to the clinical efficacy of infliximab (IFX) in patients with CD. Between January 2013 and December 2015, 100 consecutive patients with active CD and 50 age- and sex-matched control individuals were recruited from a tertiary center. Their serum IL-9 levels were measured using an enzyme-linked immunosorbent assay. Correlations between the serum IL-9 levels and disease severity were examined. The serum IL-9 level was explored as a predictor of clinical remission and mucosal healing at week 30 in 50 patients for whom IFX therapy was administered. The serum IL-9 levels were significantly higher in the patients with active CD (22.0 pg/mL) than in the control individuals (6.3 pg/mL) (P < 0.001); they differed according to disease severity (moderate-to-severe CD: 29.1 pg/mL versus mild CD: 12.9 pg/mL) (P < 0.001), and they correlated well with the clinical activity of CD. IFX lowered the serum IL-9 level in patients who achieved efficacy at week 30. The areas under the curves for the IL-9 levels at weeks 14 and 30 that could predict clinical remission and mucosal healing at week 30 were 0.803 and 0.752 and 0.746 and 0.781, respectively. Serum IL-9 levels correlate with disease severity and the clinical efficacy of IFX in patients with CD, and IL-9 may be a promising novel biomarker for CD monitoring.

P408 Long-term efficacy of infliximab in patients with ulcerative colitis – an observational study from a single center in Norway

Background: TNF inhibitor is a well-established treatment in moderate to severe ulcerative colitis (UC). Treatment failure occurs in a large proportion of patients. There are few long-term observational real-life studies and the clinical course in the period following discontinuation of TNF treatment, has been little focused. Methods: We conducted a systematic review of all patient records for the period of 2001–2014. Demographic, clinical and management data were collected. In addition, disease activity, calprotectin level and ongoing use of TNF inhibitor and/or other anti-inflammatory medication at the last follow-up control was especially emphasized. All data were analysed using PASW version 24. Results: A total of 87 patients started infliximab treatment until the end of 2011. Of these, 61% were men, mean age 41. Seventy-nine percent had extensive colitis (E3). At start of anti-TNF therapy, 75% used concomitant steroids and 25% used immunomodulators (IMM). 1-year evaluation: Complete remission (CR) (calprotectin <100 mg/kg) was achieved in 45% and partial remission (PR) in 14%. At 1 year, 41% of the patients had discontinued infliximab due to treatment failure or severe adverse events. The last evaluation (up to 14 years of observation; median 6 years): Eleven patients (13%) were in CR and 3 (3%) in PR, 25 (29%) had undergone colectomy, and 27 (31%) had stopped infliximab due to remission. Of these, 10 patients (37%) restarted anti-TNF (4 years observation), all with complete response. After discontinuation of TNF inhibitor (up to 13 years of observation; median 4 years): Sixty-five percent of the patients were classified as being in CR and 23% in PR at the last evaluation (excluding all post-colectomy patients). Thirty-seven percent of the patients were using IMM and 19% used oral steroids. Conclusions: Among patients starting infliximab only 13% were in long-term complete remission. Stopping infliximab due to remission was successful in one third. A high proportion of patients were in steroid free complete remission median 4 years after stopping infliximab. Exit strategies after successful remission-induction anti-TNF treatment in UC patients is highly requested.

Prognostic factors for long-term infliximab treatment in Crohn's disease patients: a 20-year single centre experience.

The long-term efficacy of infliximab in patients with Crohn's disease is suboptimal. To study prognostic factors for real-life long-term effcacy of infliximab in Crohn's disease. All consecutive Crohn's disease patients treated with infliximab at a tertiary centre were retrospectively analysed. Only patients who received scheduled infliximab maintenance treatment were considered. Patient- and disease-related factors were used to identify independent predictors of infliximab failure-free survival using Cox proportional hazards regression. Of 1031 patients with Crohn's disease, 261 were eligible for inclusion. Median time on infliximab was 2.4 [IQR 1.4-4.7] years, and 65 (24.9%) patients experienced infliximab failure. Estimated 5-year infliximab failure-free survival was 65.9% (95% CI 58.3-73.5). Multivariate Cox regression identified disease duration ≥1 year (HR 2.5 (95% CI 1.2-5.2), P = 0.02), L1 disease location [HR 2.0 (1.1-3.5), P = 0.02], prior anti-TNF use [HR 2.3 (1.1-4.8), P = 0.03], haemoglobin <13.5 g/dL [HR 2.3 (1.2-4.4), P = 0.02], not using therapeutic drug monitoring [HR 8.0 (4.1-15.6), P = 1 × 10(-9) ], and first dose optimisation within first year [HR 3.7 (2.1-6.6), P = 5 × 10(-6) ] as independent predictors of infliximab failure-free survival. Stratifying patients into risk groups resulted in estimated 3-year infliximab failure-free survival rates ranging from 95.3% (94.2-96.4) to 26.3% (8.6-44.0) depending on the number of risk factors (P = 8 × 10(-13) ). This study identified several easy to obtain predictors of infliximab failure in patients with Crohn's disease, and these are in line with previous reports. Those with a high-risk profile for infliximab failure in whom infliximab initiation is considered, should be treated as early as possible making use of therapeutic drug monitoring.

Changes in cytokine profile may predict therapeutic efficacy of infliximab in patients with ulcerative colitis.

Infliximab is an established therapy for ulcerative colitis (UC). The aim of this study was to examine various serum cytokine levels and to identify possible markers predictive of therapeutic efficacy of infliximab for UC patients. Twenty-one patients with moderately active UC were given intravenous infliximab (5 mg/kg) at 0, 2, and 6 weeks as induction therapy. The serum levels of 17 cytokines were determined using a Bio-Plex suspension array system before and 8 weeks after induction therapy. Partial Mayo score (PMS) and serum C-reactive protein levels were used for the determination of clinical activities at 0 and 8 weeks after the treatment. The overall therapeutic effect was determined at 26 weeks according to the PMS. The median value of the PMS decreased significantly 8 weeks after the treatment (from 6 to 1.5, P < 0.05). However, C-reactive protein levels did not change significantly. Levels of serum interleukin (IL)-8 (P < 0.05) and macrophage inflammatory protein-1β (P < 0.005) significantly decreased 8 weeks after the induction. Serum levels of the other 15 cytokines did not change significantly. At 26 weeks, 13 of 20 patients (65%) were responders while 7 patients were non-responders. Levels of serum IL-6 at 8 weeks were significantly lower in responders than in non-responders (P < 0.05). Serum IL-8 and macrophage inflammatory protein-1β seem to be sensitive markers for UC patients treated with infliximab, while IL-6 at 8 weeks after induction therapy may be predictive of subsequent response to infliximab.

Efficacy of Infliximab in Patients with Refractory Uveitis Associated with Behcet Disease

Background: Ocular involvement in Behcet disease is responsible for severe morbidity by causing nongranulomatous panuveitis and retinal vasculitis. In some cases, recurrent attacks cannot be controlled by conventional immunosuppressives and corticosteroid or interferon. The aim of this study is to investigate the efficacy of infliximab treatment in patients with refractory uveitis associated with Behcet disease.Methods: Nine patients with Behcet disease related uveitis were included in the study. Uveitis had been refractory to treatment with either a combination of cyclosporine-A, azathioprine, and corticosteroid or interferon α-2a monotherapy in all patients. Patients received infliximab infusions (5 mg/kg) at weeks 0, 2, 6, and every 8 weeks thereafter. In patients receiving interferon α-2a at the time of initiation of infliximab therapy, interferon was ceased before starting infliximab. We evaluated visual acuity, ocular inflammatory attacks, and adverse effects.Results: The Patients consist of seven men and two women; their ages ranging from 28 to 49 years. The mean follow-up after initiating infliximab therapy was 14.4 months. Four of the patients had no ocular inflammatory attacks during follow-up. Two of the remaining five patients developed a mild anterior uveitis only once after the start of infliximab infusions. Three of the patients had a mild panuveitis attack 2-4 months after the initiation of infliximab therapy. Best corrected visual acuity (BCVA) improved at least 2 lines in 6 (33.3%) eyes, from no light perception to hand motion in one eye, and from light perception to hand motion in another eye. BCVA remained stable in 9 (50%) eyes. In one patient, infliximab treatment was terminated owing to HPV+genital warts at 8th month of therapy. No other adverse effects were noticed apart from temporary infusion reaction and urticaria-like rash.Conclusions: With a follow-up period ranging from seven to thirty three (7-33) months, infliximab was effective and well tolerated in refractory Behcet uveitis.

AB1184 Effects of infliximab treatment on growth in children with juvenile idiopathic arthritis (JIA)

BackgroundInfliximab (a human murine chimeric anti-tumour necrosis factor alpha monoclonal antibody) is known to decrease disease activity of juvenile idiopathic arthritis (JIA) but its effect on longitudinal growth in relation...

AB0464 Comparative efficacy of infliximab in patients with rheumatoid arthritis (RA) depending on a total dose (quantity of infusions)

ObjectivesTo estimate efficacy of infliximab (INF) in patients (pts) with RA depending on a total dose (quantity of infusions) of this biologic.MethodsThe cohort of 135 pts with active RA despite...

SAT0153 Early response to infliximab therapy predicts long-term disease activity outcomes in patients with rheumatoid arthritis: Results from the czech national biological therapy registry (ATTRA)

BackgroundInfliximab is well-established tumor necrosis factor α inhibitor in management of rheumatoid arthritis (RA). It has shown efficacy in many randomized controlled clinical trials and registries.ObjectivesTo assess the efficacy of...

Sa1144 The Efficacy of Infliximab in Patients With Corticosteroid Refractory Ulcerative Colitis WHO Responded to Tacrolimus As Remission Induction Therapy, but Relapsed While Under Maintenance Tacrolimus

Sa1144 The Efficacy of Infliximab in Patients With Corticosteroid Refractory Ulcerative Colitis WHO Responded to Tacrolimus As Remission Induction Therapy, but Relapsed While Under Maintenance Tacrolimus

Long-term Outcome of Perianal Fistulizing Crohn's Disease Treated With Infliximab

Little is known about the long-term efficacy of infliximab for patients with fistulizing perianal Crohn's disease. We evaluated outcomes and predictors of outcomes in these patients. The medical records of 156 patients treated with infliximab for fistulizing perianal Crohn's disease at 2 referral centers from 1999 through 2010 were reviewed through September 2011. Cumulative probabilities of fistula closure and recurrence were estimated by using the Kaplan-Meier method. Predictors of outcomes were identified by using a Cox proportional hazards model. When infliximab treatment began, only 17.9% of patients had a simple fistula; seton drainage was performed for 97 patients (62%). Concomitant immunosuppressants were given to 90 patients (56%). After a median follow-up period of 250 weeks, 108 patients (69%) had at least 1 fistula closure. Cumulative probabilities of first fistula closure were 40% and 65% at 1 and 5 years, respectively. Factors that predicted fistula closure were ileocolonic disease (hazard ratio [HR] = 1.88), concomitant immunosuppressants (HR = 2.58), duration of seton drainage <34 weeks (HR = 2.31), and long duration of infliximab treatment (HR = 1.76). Of the 108 patients with fistula closure, cumulative probabilities of first fistula recurrence were 16.6% and 40.1% at 1 and 5 years, respectively. Forty-four patients (28.9%) developed an abscess during follow-up. A number of infliximab infusions greater than 19 was associated with less abscess recurrence (HR = 0.33). At the maximal follow-up time, 55% of patients had fistula closure. About two-thirds of patients with fistulizing perianal Crohn's disease had fistula closure, and one-third had fistula recurrence after infliximab initiation. Combination therapy, duration of seton drainage less than 34 weeks, and long-term treatment with infliximab were associated with better outcomes.