Efficacy of Infliximab in Patients with Intestinal Behcet's Disease Refractory to Conventional Medication
Efficacy of Infliximab in Patients with Intestinal Behcet's Disease Refractory to Conventional Medication
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DOI：
10.2169/internalmedicine.52.0589
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发表时间：
2013-01-01
影响因子：
1.2
通讯作者：
Maeda, Shin
中科院分区：
文献类型：
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作者：
Kinoshita, Hiroto;Kunisaki, Reiko;Maeda, Shin
目的通过回顾性队列研究，探讨英夫利昔单抗（IFX）治疗肠道白塞病（BD）的近期和长期疗效及安全性。方法在同一门诊连续就诊的43例肠道BD患者中，15例病情活跃且接受标准治疗的患者每8周输注IFX （5 mg/kg体重）。治疗前对患者进行临床和内镜评估，然后在10周，12个月和24个月后评估临床反应，定义为肠道症状的显着改善和c反应蛋白（CRP）水平的降低。结果在第10周，12名患者（80%）对IFX有反应，8名患者（53%）缓解，无肠道症状，CRP水平正常。11例患者中有7例（64%）在12个月时维持对IFX的反应，8例患者中有4例（50%）在24个月时维持对IFX的反应。在入院时接受强的松龙治疗的7名患者中，有5名患者的类固醇剂量减少。暴发性肠道BD可预测对IFX无反应。不良反应包括1例输液反应和1例发热，很可能与IFX有关。结论IFX治疗难治性肠道BD有效、安全。
Objective To investigate the short-and long-term efficacy and safety of infliximab (IFX) in intestinal Behcet's disease (BD) patients in a retrospective cohort study.Methods Among 43 consecutive patients with intestinal BD presenting at the same clinic, 15 with active disease and receiving standard treatment were given IFX infusions (5 mg/kg body weight) every eight weeks. The patients were clinically and endoscopically evaluated before treatment, then assessed after 10 weeks, 12 months and 24 months for a clinical response, defined as a significant improvement in intestinal symptoms and a reduced C-reactive protein (CRP) level.Results At week 10, 12 patients (80%) exhibited a response to IFX, with eight (53%) in remission with no intestinal symptoms and normal CRP levels. A response to IFX was maintained in seven of the 11 patients (64%) available at 12 months and in four of the eight patients (50%) available at 24 months. Of the seven patients receiving prednisolone at entry, five responders had their steroid doses reduced. Fulminant intestinal BD was predictive of an absence of response to IFX. The adverse effects comprised one infusion reaction and one case of fever, most likely related to IFX.Conclusion IFX is effective and safe in patients with refractory intestinal BD.