Predictors of early response to infliximab in patients with ulcerative colitis
Predictors of early response to infliximab in patients with ulcerative colitis
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DOI：
10.1002/ibd.20054
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发表时间：
2007-02-01
影响因子：
4.9
通讯作者：
Rutgeerts, Paul
中科院分区：
文献类型：
--
作者：
Ferrante, Marc;Vermeire, Severine;Rutgeerts, Paul
背景资料：我们的目的是报告的结果英夫利西单抗（IFX）在溃疡性结肠炎（UC）患者从一个单一的中心，并确定早期临床respons.Methods的预测：第一个100 UC患者（45名女性，中位年龄，37.9岁）谁收到IFX在一个单一的中心。在第0、2和6周，84名患者接受5 mg/kg IFX，37名患者接受3剂lFX诱导。入选前通过乙状结肠镜检查评估的马约内镜分项评分分别为1、2和3分的患者分别为5%、52%和43%。60%患有全结肠炎，63%接受伴随免疫抑制治疗，9%为主动吸烟者，64%的C反应蛋白5 mg/dL，44%为pANCA+/ASCA-。5例患者接受lFX，因为严重的急性结肠炎难治性静脉注射皮质类固醇。结果：早期完全和部分临床反应观察到41%和24%的患者。有早期临床应答的患者明显比无应答者年轻（中位年龄，35.7岁对41.6岁，P = 0.041）。pANCA+/ASCA-患者的早期临床应答显著较低（55% vs 76%;比值比[OR] = 0.40（0.16-0.99），P = 0.049）。伴随免疫抑制治疗和IFX诱导方案的使用不影响早期临床应答。只有我的5例患者接受IFX治疗急性类固醇难治性结肠炎需要结肠切除术在2 months.Conclusions：IFX是一种有效的治疗UC，如65%的早期临床反应。首次输注lFX时pANCA+/ASCA-血清型和年龄较大与次优早期临床应答相关。
Background: Our objective is to report the outcome of infliximab (IFX) in ulcerative colitis (UC) patients from a single center and to identify predictors of early clinical response.Methods: The first 100 UC patients (45 female; median age, 37.9 years) who received IFX at a single center were included. Eighty-four patients received 5 mg/kg IFX, and 37 patients received a 3-dose lFX induction at weeks 0, 2, and 6. The Mayo endoscopic subscore, assessed by sigmoidoscopy before inclusion, was 1, 2, and 3 in 5%, 52%, and 43% of patients, respectively. Sixty percent had pancolitis, 63% were on concomitant immumosuppressive therapy, 9% were active smokers, 64% had C-reactive protein 5 mg/dL, and 44% were pANCA+/ASCA-. Five patients received lFX because of severe acute colitis refractory to intravenous corticosteroids.Results: Early complete and partial clinical responses were observed in 41% and 24% of patients. Patients with early clinical response were significantly younger than nonresponders (median age, 35.7 versus 41.6 years, P = 0.041). Patients who were pANCA+/ASCA- had a significantly lower early clinical response (55% versus 76%; odds ratio [OR] = 0.40 (0.16-0.99), P = 0.049). Concomitant immunosuppressive therapy and the use of an IFX induction scheme did not influence early clinical response. Only I of 5 patients who received IFX for acute steroid-refractory colitis required colectomy within 2 months.Conclusions: IFX is an efficient therapy in UC, as shown by 65% early clinical response. A pANCA+/ASCA- serotype and an older age at first lFX infusion are associated with a suboptimal early clinical response.