Infliximab for refractory ulcerative proctitis
Infliximab for refractory ulcerative proctitis
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DOI：
10.1111/j.1365-2036.2010.04293.x
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发表时间：
2010-06-01
影响因子：
7.6
通讯作者：
Peyrin-Biroulet, L.
中科院分区：
文献类型：
--
作者：
Bouguen, G.;Roblin, X.;Peyrin-Biroulet, L.
背景：英夫利昔单抗治疗溃疡性直肠炎的疗效尚不清楚。目的评价英夫利昔单抗治疗难治性直肠炎的临床、生物学和内镜疗效。方法回顾420例英夫利昔单抗治疗溃疡性结肠炎的临床资料。2005年至2009年间，在6个转诊中心，13名患者接受了英夫利昔单抗治疗难治性溃疡性直肠炎。结果在英夫利昔单抗诱导治疗后，9/13例患者（69%）完全缓解（定义为没有腹泻和血液），2/13例（15%）部分缓解，2/13例（15%）主要无反应。中位随访为17个月（范围3-48）。在英夫利昔单抗诱导治疗后出现临床反应的11例患者中，有9例（82%）患者在最后随访时仍保持疗效。在最后的随访中，所有9例患者均保持了临床反应，直肠疾病消失。在英夫利昔单抗诱导治疗后，平均CRP水平从12.8 mg/L下降到4.7 mg/L。7例患者在使用英夫利昔单抗前后进行了内镜评估，4例患者粘膜病变改善，2例患者持续轻度内镜活动，1例患者无改善。1例患者行直结肠切除术。结论英夫利昔单抗治疗难治性溃疡性直肠炎可有效诱导和维持临床疗效。
P>BackgroundEfficacy of infliximab in treating ulcerative proctitis remains unknown.AimTo evaluate the clinical, biological and endoscopic efficacy of infliximab therapy in refractory proctitis.MethodsThe 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 centres between 2005 and 2009.ResultsFollowing infliximab therapy induction, 9/13 patients (69%) had a complete response (defined as absence of diarrhoea and blood), 2/13 (15%) had a partial response and 2/13 (15%) were primary nonresponders. 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 follow-up. Disappearance of rectal disorders was observed in all nine patients who maintained clinical response at last follow-up. 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 seven patients, showing an improvement in mucosal lesions in four patients, persistent mild endoscopic activity in two patients and no improvement in one patient. One patient underwent proctocolectomy.ConclusionInfliximab therapy seems to be effective in inducing and maintaining a clinical response in refractory ulcerative proctitis.