Aliment Pharmacol Ther 2010; 32: 522–528


Background  Randomized, controlled trials have demonstrated that anti-TNF agents are efficacious in inducing remission in cases of Crohn’s disease and ulcerative colitis. However, response rates for anti-TNF agents in ‘real life’ clinical practice are less well-defined.

Aims  To examine the response rates and long-term outcomes of infliximab and adalimumab treatment for out-patients with ulcerative colitis and to study the variables associated with response rates.

Methods  In a prospective study, a single-centre out-patient cohort was treated and followed up according to a structured protocol of clinical care. Response to treatment was assessed using a physician’s global assessment that focused on normalization of bowel frequency, absence of blood with defecation and tapering of corticosteroids to zero.

Results  Fifty-three ulcerative colitis patients were included in the study. Responses to induction therapy were 96.4% (27/28) for infliximab and 80% (20/25) for adalimumab (P = 0.0889). Responses to maintenance therapy were similar: infliximab 77.8% (14/18) and adalimumab 70.0% (14/20) (P = 0.7190). Multivariate analyses of the induction and maintenance responses did not reveal confounding elements. No new safety signals were identified.

Conclusions  This long-term follow-up of a single-centre cohort of ulcerative colitis patients demonstrates that ‘real-life’ out-patient treatment with infliximab and adalimumab is effective in induction and maintenance of response.