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Research ArticleArticle

Ten-year Followup of Infliximab Therapy in Rheumatoid Arthritis Patients with Severe, Longstanding Refractory Disease: A Cohort Study

Filip De Keyser, Joris De Kock, Hermine Leroi, Patrick Durez and René Westhovens
The Journal of Rheumatology June 2014, jrheum.131270; DOI: https://doi.org/10.3899/jrheum.131270
Filip De Keyser
Belgium From Department BVBA; Department of Rheumatology, of Rheumatology, Ghent University, Pôle deGhent; Recherche MSD  en  Rhumatologie, Université Catholique Institut de de Louvain Recherche and Expérimentale Cliniques Universitaires et Clinique, Saint-Luc,  of Brussels; Development Skeletal and Biology Regeneration and Engineering KU Leuven; Research and Department Center, Department  of  Rheumatology, Supported University; Department F. De Keyser, by H. of an MD; Leroi, Rheumatology, University unrestricted J. MSD De Kock, Hospitals Belgium educational Pôle MD, de BVBA, Leuven, Department Recherche grant Brussels; Leuven, from of en Rheumatology, Rhumatologie,  MSD Belgium.  P. Durez, Belgium.  MD,  Ghent  Institut de Recherche Expérimentale et Clinique, Université Catholique de  Development Louvain PhD, Skeletal and Cliniques and Biology Regeneration and Universitaires Engineering KU Leuven; Saint-Luc; Research and Department R. Center, Westhovens, Department of  MD,  of  Rheumatology, University Hospitals Leuven.  Address 0K12, Department correspondence of Rheumatology, to Prof. De Keyser, De Pintelaan Ghent 185, University B-9000 Hospital  Ghent,  Belgium. E-mail: filip.dekeyser@ugent.be  Accepted for publication March 26, 2014.
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Joris De Kock
Belgium From Department BVBA; Department of Rheumatology, of Rheumatology, Ghent University, Pôle deGhent; Recherche MSD  en  Rhumatologie, Université Catholique Institut de de Louvain Recherche and Expérimentale Cliniques Universitaires et Clinique, Saint-Luc,  of Brussels; Development Skeletal and Biology Regeneration and Engineering KU Leuven; Research and Department Center, Department  of  Rheumatology, Supported University; Department F. De Keyser, by H. of an MD; Leroi, Rheumatology, University unrestricted J. MSD De Kock, Hospitals Belgium educational Pôle MD, de BVBA, Leuven, Department Recherche grant Brussels; Leuven, from of en Rheumatology, Rhumatologie,  MSD Belgium.  P. Durez, Belgium.  MD,  Ghent  Institut de Recherche Expérimentale et Clinique, Université Catholique de  Development Louvain PhD, Skeletal and Cliniques and Biology Regeneration and Universitaires Engineering KU Leuven; Saint-Luc; Research and Department R. Center, Westhovens, Department of  MD,  of  Rheumatology, University Hospitals Leuven.  Address 0K12, Department correspondence of Rheumatology, to Prof. De Keyser, De Pintelaan Ghent 185, University B-9000 Hospital  Ghent,  Belgium. E-mail: filip.dekeyser@ugent.be  Accepted for publication March 26, 2014.
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Hermine Leroi
Belgium From Department BVBA; Department of Rheumatology, of Rheumatology, Ghent University, Pôle deGhent; Recherche MSD  en  Rhumatologie, Université Catholique Institut de de Louvain Recherche and Expérimentale Cliniques Universitaires et Clinique, Saint-Luc,  of Brussels; Development Skeletal and Biology Regeneration and Engineering KU Leuven; Research and Department Center, Department  of  Rheumatology, Supported University; Department F. De Keyser, by H. of an MD; Leroi, Rheumatology, University unrestricted J. MSD De Kock, Hospitals Belgium educational Pôle MD, de BVBA, Leuven, Department Recherche grant Brussels; Leuven, from of en Rheumatology, Rhumatologie,  MSD Belgium.  P. Durez, Belgium.  MD,  Ghent  Institut de Recherche Expérimentale et Clinique, Université Catholique de  Development Louvain PhD, Skeletal and Cliniques and Biology Regeneration and Universitaires Engineering KU Leuven; Saint-Luc; Research and Department R. Center, Westhovens, Department of  MD,  of  Rheumatology, University Hospitals Leuven.  Address 0K12, Department correspondence of Rheumatology, to Prof. De Keyser, De Pintelaan Ghent 185, University B-9000 Hospital  Ghent,  Belgium. E-mail: filip.dekeyser@ugent.be  Accepted for publication March 26, 2014.
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Patrick Durez
Belgium From Department BVBA; Department of Rheumatology, of Rheumatology, Ghent University, Pôle deGhent; Recherche MSD  en  Rhumatologie, Université Catholique Institut de de Louvain Recherche and Expérimentale Cliniques Universitaires et Clinique, Saint-Luc,  of Brussels; Development Skeletal and Biology Regeneration and Engineering KU Leuven; Research and Department Center, Department  of  Rheumatology, Supported University; Department F. De Keyser, by H. of an MD; Leroi, Rheumatology, University unrestricted J. MSD De Kock, Hospitals Belgium educational Pôle MD, de BVBA, Leuven, Department Recherche grant Brussels; Leuven, from of en Rheumatology, Rhumatologie,  MSD Belgium.  P. Durez, Belgium.  MD,  Ghent  Institut de Recherche Expérimentale et Clinique, Université Catholique de  Development Louvain PhD, Skeletal and Cliniques and Biology Regeneration and Universitaires Engineering KU Leuven; Saint-Luc; Research and Department R. Center, Westhovens, Department of  MD,  of  Rheumatology, University Hospitals Leuven.  Address 0K12, Department correspondence of Rheumatology, to Prof. De Keyser, De Pintelaan Ghent 185, University B-9000 Hospital  Ghent,  Belgium. E-mail: filip.dekeyser@ugent.be  Accepted for publication March 26, 2014.
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René Westhovens
Belgium From Department BVBA; Department of Rheumatology, of Rheumatology, Ghent University, Pôle deGhent; Recherche MSD  en  Rhumatologie, Université Catholique Institut de de Louvain Recherche and Expérimentale Cliniques Universitaires et Clinique, Saint-Luc,  of Brussels; Development Skeletal and Biology Regeneration and Engineering KU Leuven; Research and Department Center, Department  of  Rheumatology, Supported University; Department F. De Keyser, by H. of an MD; Leroi, Rheumatology, University unrestricted J. MSD De Kock, Hospitals Belgium educational Pôle MD, de BVBA, Leuven, Department Recherche grant Brussels; Leuven, from of en Rheumatology, Rhumatologie,  MSD Belgium.  P. Durez, Belgium.  MD,  Ghent  Institut de Recherche Expérimentale et Clinique, Université Catholique de  Development Louvain PhD, Skeletal and Cliniques and Biology Regeneration and Universitaires Engineering KU Leuven; Saint-Luc; Research and Department R. Center, Westhovens, Department of  MD,  of  Rheumatology, University Hospitals Leuven.  Address 0K12, Department correspondence of Rheumatology, to Prof. De Keyser, De Pintelaan Ghent 185, University B-9000 Hospital  Ghent,  Belgium. E-mail: filip.dekeyser@ugent.be  Accepted for publication March 26, 2014.
Roles: the Infliximab EAP Study Group
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Abstract

Objective Our study describes the 10-year followup data of the Belgian Expanded Access Program (EAP) for infliximab (IFX), which included patients with active rheumatoid arthritis who were refractory to methotrexate. The objectives of the study were to evaluate the continuation rate, reasons for discontinuation, and longterm disease control under IFX treatment, and to study baseline characteristics associated with longterm successful IFX therapy.

Methods Between February 2000 and September 2001, 511 patients were enrolled in the Belgian IFX EAP, and 507 effectively started IFX therapy. Previously reported data showed that 160 patients were still treated with IFX after 7 years of followup. We describe the therapy status, reasons for IFX discontinuation, and the level of disease activity of this subgroup after 10 years of followup. Baseline characteristics of the total EAP cohort were used to describe variables associated with longterm successful IFX treatment.

Results After 10 years of followup, 110 of the 507 patients (21.7%) were still receiving IFX treatment. In the 7-year to 10-year period, which is the focus of the current study, 16 patients were lost to followup and 34 patients discontinued IFX treatment, mainly because of loss of efficacy. Patients successfully treated with IFX for 10 years had lower baseline values for 28-joint Disease Activity Score (DAS28), patient pain scale, physician visual analog scale, and Health Assessment Questionnaire in comparison with the rest of the study cohort. The mean DAS28 level of the subgroup still taking IFX after 10 years was 2.55 ± 1.01.

Conclusion In the Belgian EAP, 21.7% of patients continued to receive maintenance IFX treatment after 10 years of followup. IFX provided good longterm disease control in these patients.

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Ten-year Followup of Infliximab Therapy in Rheumatoid Arthritis Patients with Severe, Longstanding Refractory Disease: A Cohort Study
Filip De Keyser, Joris De Kock, Hermine Leroi, Patrick Durez, René Westhovens
The Journal of Rheumatology Jun 2014, jrheum.131270; DOI: 10.3899/jrheum.131270

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Ten-year Followup of Infliximab Therapy in Rheumatoid Arthritis Patients with Severe, Longstanding Refractory Disease: A Cohort Study
Filip De Keyser, Joris De Kock, Hermine Leroi, Patrick Durez, René Westhovens
The Journal of Rheumatology Jun 2014, jrheum.131270; DOI: 10.3899/jrheum.131270
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