Early mucosal healing with infliximab improves long-term outcome, reduces need for colectomy
FRIDAY, Oct. 7 (HealthDay News) -- For patients with ulcerative colitis treated with infliximab, mucosal healing after eight weeks is associated with improved long-term clinical outcomes and a reduced likelihood of progressing to colectomy, according to a study published in the October issue of Gastroenterology.
Jean Frédéric Colombel, M.D., Ph.D., from the Universite Lille Nord de in France, and colleagues evaluated the correlation between early improvement (based on endoscopic scores) and subsequent clinical improvement in patients with ulcerative colitis treated with infliximab. Endoscopic evaluations were performed at weeks zero, eight, 30, and 54; and patients were categorized into four subgroups by week eight, based on Mayo endoscopy subscores of 0 to 3 (with 0 and 1 defined as mucosal healing). The correlation between endoscopy subscores at week eight and subsequent colectomy risk, corticosteroid use, and symptoms was evaluated.
The investigators found that, during the 54 weeks of follow-up, infliximab-treated patients with lower week eight endoscopy subscores were significantly less likely to progress to colectomy. This association was not seen in the placebo group. Lower endoscopy subscores correlated with significantly improved symptomatic and corticosteroid use outcomes at weeks 30 and 54. For patients who achieved clinical response at week eight, the trends in later clinical outcomes based on the endoscopy subscore at week eight were similar to those of the overall population of patients. No trends were noted for patients who achieved clinical remission.
"Achievement of early mucosal healing (i.e., endoscopy subscores of 0 or 1 at week eight) after treatment with infliximab may lead to better long-term clinical outcomes for patients with moderately to severely active ulcerative colitis," the authors write.
Several authors disclosed financial ties to pharmaceutical companies, including Centocor Research & Development, which manufactures infliximab, and Schering Corporation, both of which were involved in funding the study.
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