Long-term efficacy of infliximab for refractory ulcerative colitis: results from a single center experience.
Long-term efficacy of infliximab for refractory ulcerative colitis: results from a single center experience.
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DOI：
10.1186/1471-230x-14-80
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发表时间：
2014-04-23
影响因子：
2.4
通讯作者：
Nakase H
中科院分区：
文献类型：
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作者：
Yamada S;Yoshino T;Matsuura M;Minami N;Toyonaga T;Honzawa Y;Tsuji Y;Nakase H
英夫利西单抗（IFX）对难治性溃疡性结肠炎（UC）患者的长期疗效尚不清楚。本研究的目的是评估IFX治疗难治性UC患者的长期结局。回顾性评价了2003年至2013年期间在京都大学医院接受IFX治疗的33例难治性UC患者。IFX强化定义为剂量递增（高达10 mg/kg）和/或输注间隔缩短（每4-6周一次）。在接受IFX计划输注的33例患者中，24例（72.7%）在开始IFX治疗后8周内达到临床缓解。在这24例应答者中，17例（70.8%）UC复发并需要IFX强化治疗，16例（66.7%）最终通过IFX治疗（包括IFX强化治疗）维持临床缓解。在33例患者中，6例（18.2%）在IFX治疗期间接受结肠切除术。多变量回归分析显示，开始IFX治疗后两周血清C-反应蛋白（CRP）浓度<5 mg/L是IFX诱导治疗临床反应阳性的预测因子。在接受IFX治疗的UC患者中未发生严重不良事件。IFX强化对于长期维持缓解和预防难治性UC患者结肠切除术是必要的。
The long-term efficacy of infliximab (IFX) for patients with refractory ulcerative colitis (UC) is unclear. The aim of this study was to assess the long-term outcomes of IFX treatment in patients with refractory UC. Thirty-three patients with refractory UC who received IFX treatment at Kyoto University Hospital between 2003 and 2013 were retrospectively evaluated. IFX intensification was defined as a dose escalation (up to 10 mg/kg) and/or shorter intervals between infusions (every 4–6 weeks). Of the 33 patients who received scheduled infusions of IFX, 24 (72.7%) achieved clinical remission within 8 weeks after initiating IFX treatment. Of these 24 responders, 17 (70.8%) experienced a relapse of UC and required IFX intensification, and 16 (66.7%) eventually maintained clinical remission with IFX treatment, including IFX intensification. Of the 33 patients, 6 (18.2%) underwent colectomy during IFX treatment. Multivariate regression analysis showed that a serum C-reactive protein (CRP) concentration <5 mg/L two weeks after starting IFX was a predictor of a positive clinical response to IFX induction therapy. No severe adverse events occurred in UC patients treated with IFX. IFX intensification was necessary for long-term maintenance of remission and to prevent colectomy in patients with refractory UC.