Clinical experience with infliximab for Crohn’s disease: RESULTS Part 3

6 May
2012

The patient demographics and characteristics did not differ significantly between responders and nonresponders (Table 3). Furthermore, response rates did not differ between those with and those without concomitant immune modifiers (75% and 71%, respectively; P=0.568), or with the number of infliximab infusions used for induction (one-, two- or three-dose infliximab: 73%, 100% and 73%, respectively; P=0.696). The mean duration of response in patients using concomitant immune modifiers at the time of the infliximab infusions was 14 weeks, while the duration of response in patients not using immune modifiers was 13.5 weeks (P=0.912).
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TABLE 3
Characteristics and demographics of patients with inflammatory and/or fistulizing Crohn’s disease who responded (responders) or did not respond (nonresponders) to treatment with infliximab

Responders (n=80)Nonresponders (n=29)P
Demographics
Mean age, years (range)38.0 (18-78)40.8 (25-79)0.128
Mean duration of disease, years (range)11.8 (1-31)14.1 (2-26)0.478
Male:female42:3815:140.943
Smoker, n (%)9 (11)2 (7)0.494
Extraintestinal manifestations, n (%) 6 (8)5 (17)0.281
Previous total parenteral nutrition, n (%)7 (9)1 (3)0.348
Previous surgery, n (%)55 (69)20 (69)0.983
Disease distribution
Small bowel only, n (%)15 (19)10 (34)
Colon only, n (%)14 (18) 0 (0)
Colon and small bowel, n (%)51 (64)19 (66)0.051
Indication for infliximab
Inflammatory disease only, n (%)36 (45)18 (62)
Fistulizing disease only, n (%)31 (39)7 (24)
Inflammatory and fistulizing disease, n (%)13 (16)4 (14)0.267
Concomitant medication
6-Mercaptopurine, azathioprine, methotrexate, n (%)56 (70)19 (66)0.571
Mesalamine, n (%)18 (23) 8 (28)0.210
Corticosteroid, n (%) 22 (28)10 (34)0.528

Of the disease sites, colonic disease seemed to respond most favourably to treatment with infliximab. The response rate was 60% in those with Crohn’s disease isolated to the small bowel, 100% in those with Crohn’s disease isolated to the colon and 73% in those with Crohn’s disease that involved both the small bowel and the colon; however, this difference did not reach statistical significance (P=0.051). In addition, the response rate did not vary relative to disease type; the response rate was 67% for patients with inflammatory disease, 82% for those with fistulizing disease, and 76% for those with both inflammatory and fistulizing disease (P=0.267).

Corticosteroid tapering

During the initiation and interval of infliximab therapy, 32 patients were receiving concomitant corticosteroid therapy. Seventeen patients (53%) were able to reduce the dosage of corticosteroid used; of those, nine (28%) were able to discontinue corticosteroid use.

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