- Loss of response (LOR) to maintenance infliximab therapy affects 36% of patients receiving the drug for Crohn's disease (CD), and may be prevented by combining with immunosuppression (IMM) therapy, according to a meta-analysis.
Why this matters
- Combination IMM therapy may be advised during infliximab maintenance.
- Meta-analysis of 26 studies (n=3187) after search of PubMed, EMBASE, and the Cochrane Library.
- 22 of the studies were observational; 4 were randomized controlled trials (RCTs).
- LOR was defined as reemergence of disease activity after achieving induction response, combined with need for alternative therapy.
- Funding: National Natural Science Foundation of China.
- At a median follow-up of 1.05 years, 36% (95% CI, 29%-42%) of patients with CD developed infliximab LOR.
- The incidence of LOR was increased by these factors:
- perianal lesions (OR, 1.87; P=.02);
- colon involvement (OR, 2.56; P=.02); and
- younger age at CD onset (weighted mean difference, −0.79; P=.01).
- The incidence of LOR was decreased by 58% in patients receiving IMM therapy (OR, 0.42; P=.001).
- No double-blind RCTs were included; most studies observational.
- Small sample sizes per study.