Poster (15W162)

Retrospective Audit of the Utilization of Infliximab in Inflammatory Bowel Disease Patients at a Single Centre over a 10-year Period

Author(s)

Hannah O’Driscoll, Dr Geraldine Mc Cormack

Department(s)/Institutions

Midlands Regional Hospital Tullamore, Graduate Entry Medical School University of Limerick.

Introduction

Infliximab (IFX) is a monoclonal antibody against TNF-alpha with established efficacy in moderate to severe Inflammatory Bowel Diseases (IBD). Clinical trials have established the efficacy of IFX in the induction and maintenance of remission in moderate to severely active Crohns Disease (CD). Efficacy has also been established in acute severe and steroid dependent Ulcerative Colitis (UC) and refractory pouchitis.

Aims/Background

This study reviews the use of IFX at a single center over a 10-year period to evaluate treatment indications, outcomes, durations of treatment, reasons for discontinuing and adverse events. Service demands of providing an IFX infusion service were also examined.

Method

Retrospective review of patients treated with IFX at the Midland Regional Hospital Tullamore over a 10-year period (01/07/2005 to 1/7/2015). Patients were identified from hospital and pharmacy records, all patients receiving at least one dose during the study period were included. Data was analysed using Microsoft Excel 2010.

Results

Fifty-eight IBD patients were treated, with an increasing number over the study period. Sixteen patients are currently having maintenance infusions. Fifteen patients had an induction regimen only, 17 went on maintenance treatment (mean duration 23 months) and subsequently stopped treatment. Surgical intervention was the most common reason to stop maintenance therapy. All patients commencing maintenance therapy were on 8 weekly infusions initially, this interval was shortened in 11 cases and dose escalation occurred in 2 cases. Adverse events occurred in 6 cases, most commonly skin rashes and arthralgias. There was one death during the study period from an unrelated underlying condition

Conclusions

The audit demonstrates an increasing utilization of IFX in the management of IBD over the study period. Treatment protocols at our centre were compliant with best practice guidelines. Treatment outcomes and adverse events were similar to published data. Increased utilization of biologics and the complex multidisciplinary care required for this cohort of IBD patients has significant implications for service providers.

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