INFLIXIMAB FOR REFRACTORY ULCERATIVE PROCTITIS

International audienceBackground: Efficacy of infliximab in treating ulcerative proctitis is unknown. Aim: To evaluate clinical, biological and endoscopic efficacy of infliximab therapy in refractory proctitis. Methods: The charts of 420 patients treated with infliximab for ulcerative colitis were reviewed. Thirteen patients were treated with infliximab for refractory ulcerative proctitis in six referral centers between 2005 and 2009. Results: Following infliximab therapy induction, 9/13 patients (69%) had a complete response (defined as absence of diarrhea and blood), 2/13 (15%) had a partial response and 2/13 (15%) were primary non-responders. The median follow-up was 17 months (range, 3-48). Among the 11 patients with clinical response after infliximab induction therapy, 9 (82%) patients maintained response at last news. Disappearance of rectal disorders was observed in all 9 patients who maintained clinical response at last news. Following infliximab induction therapy, the mean CRP level fell from 12.8 mg/L to 4.7 mg/L. Endoscopic evaluation was performed before and after infliximab in 7 patients, showing an improvement in mucosal lesions in 4 patients, persistent mild endoscopic activity in 2 patients, and no improvement in one patient. One patient underwent proctocolectomy. Conclusion: Infliximab therapy seems to be effective in inducing and maintaining clinical response in refractory ulcerative proctitis