What are the risk factors for relapse of inflammatory bowel disease (IBD) following cessation of infliximab therapy?

Updated: Oct 17, 2017
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Answer

Cessation of infliximab therapy, even in patients who are in prolonged remission, is associated with high rates of disease flare. In a study of 115 patients with Crohn disease who were treated for a minimum of 1 year with infliximab and an antimetabolite, who had at least 6 months of corticosteroid-free remission, and who subsequently stopped infliximab therapy, 45% (52/115) had a relapse at a median of 28 months’ follow-up, with a 1-year relapse rate of 43.9%. [97] Risk factors for relapse included male sex, leukocyte count greater than 6.0 × 109/L, C-reactive protein level of 5.0 mg/L or greater, and a fecal calprotectin level of 300 µg/g or more. Re-treatment with infliximab was successful in 88% of patients who had a relapse. [97]


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