Maintenance of clinical benefit in Crohn’s disease patients after discontinuation of infliximab: long-term follow-up of a single centre cohort


Dr R. N. Fedorak, Division of Gastroenterology, University of Alberta, Zeidler Ledcor Centre, Edmonton, AB T6G 2X8, Canada.


Aliment Pharmacol Ther 2010; 32: 1129–1134


Background  Tumour necrosis factor-blockade with infliximab has advanced the treatment of Crohn’s disease. While infliximab is efficacious, it remains to be determined whether patients who enter clinical remission with an anti-tumour necrosis factor therapy can have their treatment stopped and retain the state of remission.

Aim  To assess in patients with Crohn’s disease who obtained infliximab-induced remission, the proportion who relapsed after infliximab discontinuation.

Methods  This longitudinal cohort study examined patients from a University-based IBD referral centre. Forty eight patients with Crohn’s disease in full clinical remission and who then discontinued infliximab were followed up for up to 7 years. Crohn’s disease relapse was defined as an intervention with Crohn’s disease medication or surgery.

Results  Kaplan–Meier analysis of the proportion of patients with sustained clinical benefit demonstrated that 50% relapsed within 477 days after infliximab discontinuance. In contrast, 35% of patients remained well, and without clinical relapse, up to the end of the nearly 7-year follow-up.

Conclusions  In patients with Crohn’s disease with an infliximab-induced remission, stopping infliximab results in a predictable relapse in a majority of patients. Nevertheless, a small percentage of patients sustain a long-term remission.