P402. Predictors of relapse in patients with ulcerative colitis in remission after one-year of infliximab therapy
T. Molnár1, P.L. Lakatos2, K. Farkas1, A. Bálint1, F. Nagy1, Z. Szepes1, P. Miheller3, K. Palatka4, T. Wittmann1, 1University of Szeged, First Department of Medicine, Szeged, Hungary, 2Semmelweis University, First Department of Medicine, Budapest, Hungary, 3Semmelweis University, Second Department of Medicine, Budapest, Hungary, 4University of Debrecen, Second Department of Medicine, Debrecen, Hungary
Some of the most important questions relating to the use of biological therapy in inflammatory bowel diseases concern the duration of maintenance therapy. The RASH study revealed that previous biological therapy and dose intensification are associated with the need for and the time to the restarting of biological therapy in Crohn's disease.
Fifty-one UC patients (female/male ratio: 28/23, mean age at the diagnosis 31 years [range 17–60]) who had achieved clinical remission following one-year of infliximab therapy and for whom infliximab was then discontinued participated in this prospective observational study. 15.7% of the patients already received previous course of infliximab. Clinical relapse was defined as a partial Mayo score of >3 points. Data were collected from four Hungarian IBD centres.
Biological therapy was restarted within one year of treatment cessation in 33.3% of the patients. Logistic regression analysis revealed that only previous biological therapy (p = 0.021, OR: 6.81, 95% CI: 1.15–40.4) was associated with the need of restarting infliximab therapy. None of the data relating to patients' smoking habits, gender, the presence of extraintestinal manifestation, concomitant steroid and immunosuppressive therapy, CRP level and previous surgical procedures showed an association with the need for restarting biological therapy.
Biological therapy was restarted a median of 12 months after discontinuation in more than every third UC patients who had been in clinical remission following one-year of infliximab therapy. Our results suggest that, in the event of the presence of previous biological therapy as a predictive factor, infliximab therapy should probably be continued for more than one year.