Clinical and Endoscopic Remission Among patients with Inflammatory Bowel Diseases Treated with Infliximab and Its Biosimilar

Background: Inflammatory bowel diseases (IBD) include ulcerative colitis (UC) and Crohn’s disease (CD) are chronic, progressive, immunomodulated inflammatory diseases of the gastrointestinal tract. Treatment goals in IBD have evolved greatly. Aim of the study: to assess clinical and endoscopic remission rates in IBD patients treated with infliximab, infliximab biosimilar for more than 1year and assessing the correlation of scoring systems used to assess clinical remission in association with endoscopic disease activity. Patients and methods: Observational cross-sectional study involved 50 patients diagnosed with IBD (27 CD,23 UC) who responded to infliximab/ infliximab biosimilar induction therapy and subsequently received scheduled maintenance therapy and adherent to therapy for more than 1year. Ileo-colonoscopy done, endoscopic healing assessed and clinical scoring systems were used to assess correlation to endoscopic activity. Demographic, clinical and treatment variables that may affect the proportion of mucosal healing were selected and assessed if they have significant associations. Results: The clinical remission rate was 65.2% in UC, 74.1% in CD, endoscopic remission rate was 60.9% in UC, 48.1% in CD. Endoscopic healing with infliximab biosimilar was higher in CD, than those treated with infliximab (85.5% vs. 25%) with statistical significance. Endoscopic remission rates were higher in old, male, shorter treatment durations and concomitant use of azathioprine. Conclusions: Long-term remission can be achieved by treatment with infliximab and its biosimilar, especially UC. Clinical scoring systems in UC are well correlated with endoscopic activity, while clinical indices in CD are poorly correlated. Loss of response to infliximab was higher in young, female and longer duration of treatment.

Inflammatory bowel diseases, Crohn’s disease, Infliximab, Biosimilar, Ulcerative colitis

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