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Infliximab is an Effective Option in Patients with Ulcerative Colitis Previously Exposed to Full Subcutaneous Anti-Tnf Agent: Results from a Real-World Multicenter Study

DIGESTIVE AND LIVER DISEASE(2024)

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摘要
Background: Data on infliximab efficacy in bio-exposed patients with ulcerative colitis (UC) are limited. Aims: To evaluate infliximab effectiveness and its predictors in UC patients with prior exposure to subcutaneous (SC) anti-TNF agent. Methods: In this multicenter retrospective study (8 centers), we included all consecutive UC patients with prior exposure to subcutaneous anti-TNF, starting infliximab for symptomatic UC, excluding acute severe colitis. Corticosteroid-free clinical remission (CFREM) was assessed at week 14 (W14) and W52 while endoscopic improvement (CFREM + endoscopic Mayo score <= 1) was evaluated at W14. Results: Overall, 104 patients were included (pancolitis = 54.8%, primary failure to subcutaneous antiTNF = 57.4%, concomitant immunosuppressant = 53.8%, median partial Mayo score at baseline = 7[5-8]). The rate of CFREM was 33.6% (35/104) at W14 and 40.4% (42/104) at W52. At W14, endoscopic improvement was achieved in 29.8%(31/104). In multivariable analysis, concomitant immunosuppressant was associated with higher rate of CFREM at W14(OR = 2.83[1.06-7.54], p = 0.037) and W52(OR = 2.68[1.16- 6.22]; p = 0.021), while primary failure to a previous subcutaneous anti-TNF agent led to lower rate of CFREM at W14 (OR = 0.37[0.14-0.98], p = 0.046). After a median follow-up of 20.9 months[11.7-33.7]), 50.0%(52/104) patients had discontinued infliximab. Conclusion: Infliximab is an effective option in UC patients previously exposed to prior subcutaneous anti-TNF agent and should be used with concomitant immunosuppressant. (c) 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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关键词
Bio-exposed patients,Inflammatory bowel disease,Infliximab,Real-world data,Second-line treatment,Ulcerative colitis
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