What are the risk factors for relapse of Crohn disease after successful treatment with infliximab?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

In a study of 115 patients with Crohn disease who were treated for 1 year with infliximab and an antimetabolite, with at least 6 months of corticosteroid-free remission, and then followed up at 1 year (median, 28 months), nearly half (52/115; 45.2%) experienced a relapse. [98] The 1-year relapse rate was 43.9%.

In this study, risk factors for relapse included male sex, leukocyte count higher than 6.0 × 109/L, C-reactive protein (CRP) level of 5.0 mg/L or higher, and fecal calprotectin level of 300 µg/g or higher. [98] However, retreatment with infliximab was effective in 88% of patients with a relapse and was well tolerated.

Unfortunately, infliximab is immunogenic, and long holidays between infusions may result in the development of antibodies to infliximab that lead to infusion reactions, loss of efficacy, and delayed hypersensitivity reactions. [99]


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