Background Biological therapies have revolutionized the treatment of patients with inflammatory bowel disease (IBD). Infliximab (IFX) has been shown to be effective in inducing and maintaining remission in patients with Crohn's disease and ulcerative colitis. However, about one-third of the patients are primary non-responders, and up to half can lose response over time. Hence, it is important to assess which factors are related to treatment failure. Objectives We aimed to identify factors predicting clinical and endoscopic remission with IFX treatment during maintenance therapy in a Brazilian IBD referral center. Design We conducted a cross-sectional study to describe demographic, clinical, and IBD therapy-related characteristics of IBD patients treated with IFX for at least 6 months in a Brazilian referral center. Subsequently, we evaluated factors associated with clinical and endoscopic remission (primary and secondary outcomes, respectively). Methods We used descriptive statistics to summarize the essential demographic and clinical characteristics of the population. The association of sociodemographic and clinical variables with outcomes was analyzed using multivariable logistic regression. Results A total of 131 IBD patients (the mean age 41.7 years) were enrolled in this study. Clinical and endoscopic remission were observed in 79.4% and 58.2% of the patients, respectively. In the multivariable analysis, IFX therapy duration and higher albumin levels increased the likelihood of clinical remission, while previous surgery decreased its chance. Prior use of adalimumab and higher C-reactive protein levels reduced the likelihood of endoscopic remission. Conclusion In summary, this study has enhanced our understanding of the predictive factors of treatment response to IFX in a well-characterized Brazilian IBD population. Trial registration 4.254.501 and 2.903.748.

中文翻译：

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巴西炎症性肠病患者对英夫利昔单抗治疗反应的预测因素。

背景生物疗法彻底改变了炎症性肠病（IBD）患者的治疗。英夫利昔单抗 (IFX) 已被证明可有效诱导和维持克罗恩病和溃疡性结肠炎患者的缓解。然而，大约三分之一的患者是原发性无反应者，并且随着时间的推移，多达一半的患者可能会失去反应。因此，评估哪些因素与治疗失败相关非常重要。目的 我们旨在确定巴西 IBD 转诊中心维持治疗期间 IFX 治疗临床和内镜缓解的预测因素。设计 我们进行了一项横断面研究，以描述在巴西转诊中心接受 IFX 治疗至少 6 个月的 IBD 患者的人口统计学、临床和 IBD 治疗相关特征。随后，我们评估了与临床和内镜缓解相关的因素（分别为主要和次要结果）。方法我们使用描述性统计来总结人群的基本人口统计学和临床​​特征。使用多变量逻辑回归分析社会人口统计学和临床​​变量与结果的关联。结果共有131名IBD患者（平均年龄41.7岁）纳入本研究。分别有 79.4% 和 58.2% 的患者出现临床缓解和内镜缓解。在多变量分析中，IFX 治疗持续时间和较高的白蛋白水平增加了临床缓解的可能性，而之前的手术则降低了其机会。先前使用阿达木单抗和较高的 C 反应蛋白水平降低了内镜缓解的可能性。结论 总之，这项研究增强了我们对巴西 IBD 人群对 IFX 治疗反应的预测因素的理解。试用注册 4.254.501 和 2.903.748。