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

Aliment Pharmacol Ther 2010; 32: 1129–1134 Summary 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.