Long-term outcomes after infliximab discontinuation in patients with Crohn's disease: a single-center retrospective observational study
10.3760/cma.j.cn101480-20241009-00111
- VernacularTitle:克罗恩病患者使用英夫利西单克隆抗体停药后长期随访结局：一项单中心回顾性观察性研究
- Author:
Danping ZHENG
1
;
Yun QIU
1
;
Yingfan ZHANG
1
;
Baili CHEN
1
;
Yao HE
1
;
Zhirong ZENG
1
;
Minhu CHEN
1
Author Information
1. 中山大学附属第一医院消化内科，广州 510080
- Publication Type:Journal Article
- Keywords:
Crohn's disease;
Infliximab;
Anti tumor necrosis factor-α;
Drug cessation;
Relapse
- From:
Chinese Journal of Inflammatory Bowel Diseases
2025;09(4):297-302
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the long-term risk of relapse in patients with Crohn's disease (CD) who discontinued infliximab (IFX) monoclonal antibody and to identify risk factors associated with relapse.Methods:A single-center retrospective observational study was conducted from February 2006 to October 2016. The study included CD patients who were treated with scheduled IFX infusions at the First Affiliated Hospital of Sun Yat-sen University and assessed in corticosteroid-free clinical remission at the time of withdrawal were included. The primary outcome was clinical relapse. We evaluated the risk of relapse using Kaplan-Meier method. Factors associated with time to relapse was identified using the multiple Cox proportional hazards regression analysis.Results:We included 97 eligible patients, and 75 (77.3%) experienced a relapse after a median follow-up time of 124 months. Among them, 45 patients (46.4%) relapsed within 3 years after IFX withdrawal. The 1-, 2-, 3-, 5-, and 10-year relapse-free survival were 79.4%, 59.8%, 52.6%, 42.0% and 22.6%, respectively. Risk factors for relapse included age ≤ 16 ( HR = 2.62, 95% CI: 1.30-5.31; P = 0.007) and failure to achieve biological remission (CRP > 3 mg/L, HR = 2.37, 95% CI: 1.29-4.36; P = 0.006) at drug withdrawal. Induction with biologics or systemic steroids were both effective (89%-100% relieved) in relapsers. Conclusions:Nearly half of CD patients relapsed within 3 years after discontinuation of IFX treatment. Early age of discontinuation and failure to achieve serum biological remission at the time of discontinuation are independent predictors of clinical relapse.
