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Long-Term Outcomes of Infliximab Treatment in 582 Korean Patients with Crohn’s Disease: A Hospital-Based Cohort Study

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Abstract

Background and Aims

To date, no large-scale studies have evaluated long-term outcomes of infliximab (IFX) treatment in Korean patients with Crohn’s disease (CD).

Methods

We analyzed long-term clinical responses to IFX in 582 Korean CD patients who received scheduled IFX treatments at Asan Medical Center. Clinical responses were defined as maintaining IFX without major abdominal surgery (MAS) or dose intensification.

Results

Between February 2002 and July 2015, a total of 11,990 IFX infusions were administered to 582 Korean patients with CD over a median period of 36 months. At the end of follow-up, 316 (54.3 %) were still receiving IFX without MAS (71 patients, 12.2 %) or dose intensification (86 patients, 14.8 %). IFX was stopped in 109 (18.7 %) patients because of a loss of response (48 patients, 8.2 %), adverse events (30 patients, 5.2 %), or patient preferences or problems with reimbursement (31 patients, 5.3 %). The cumulative survival for maintenance of IFX without MAS or dose intensification was 89.0, 75.9, 68.3, and 50.8 % at 1, 2, 3, and 5 years, respectively. Multivariate regression analysis identified older age at the initiation of IFX (≥40 years, P = 0.006) and a longer disease duration (≥3 years, P = 0.020) as independent positive predictors of a poorer response to IFX.

Conclusions

The long-term efficacy of IFX in a large, real-life cohort of Korean patients with CD appears to be similar to that in previously published Western studies. Our findings support the early use of IFX to obtain better clinical outcomes.

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Acknowledgment

This study was supported by a Grant from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A120176).

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    Authors and Affiliations

    1. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea

      Sang Hyoung Park, Sung Wook Hwang, Min Seob Kwak, Wan Soo Kim, Jeong-Mi Lee, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Jin-Ho Kim & Suk-Kyun Yang

    2. Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

      Ho-Su Lee

    3. Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

      Yong Sik Yoon & Chang Sik Yu

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    1. Sang Hyoung Park
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    Correspondence to Suk-Kyun Yang.

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    Conflict of interest

    Suk-Kyun Yang received a research Grant from Janssen Korea Ltd., but this Grant was not related to the topic of this current study. The remaining authors have no competing interests to declare.

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    Sang Hyoung Park and Sung Wook Hwang contributed equally to this article.

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    Park, S.H., Hwang, S.W., Kwak, M.S. et al. Long-Term Outcomes of Infliximab Treatment in 582 Korean Patients with Crohn’s Disease: A Hospital-Based Cohort Study. Dig Dis Sci 61, 2060–2067 (2016). https://doi.org/10.1007/s10620-016-4105-6

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