Infliximab treatment for symptomatic Crohn's disease strictures
Infliximab treatment for symptomatic Crohn's disease strictures
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DOI：
10.1111/j.1365-2036.2008.03887.x
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发表时间：
2009-02-01
影响因子：
7.6
通讯作者：
Soule, J. -C.
中科院分区：
文献类型：
--
作者：
Pelletier, A. -L.;Kalisazan, B.;Soule, J. -C.
背景一些报道表明英夫利西单抗可能引起梗阻性症状，尽管没有确切的证据，克罗恩病（CD）住院患者通常禁用目的评价英夫利西单抗对CD患者小肠症状性狭窄的影响，并确定临床反应的预测因素。方法本回顾性研究包括常规治疗后接受英夫利西单抗治疗的症状性患者。失败了短期（第8周）和长期的结果进行了分类，根据预定义的标准为完全，部分反应，或failure.ResultsBefore英夫利西单抗，18例完全梗阻或间歇性慢性腹痛。14例患者接受皮质类固醇治疗，13例接受免疫抑制剂治疗。第8周时，完全缓解10例，部分缓解7例，无效1例。14例患者在第8周后继续接受英夫利西单抗维持治疗。在最近的评估中（中位随访时间：18个月），8例患者接受英夫利西单抗维持治疗;只有8例仍在接受泼尼松治疗;有5例完全缓解，10例部分缓解和3例失败。启动泼尼松或增加其剂量是唯一的因素与短期的完全respons.ConclusionsInfliximab可能是有效的症状性狭窄的患者从CD，并应在考虑手术前进行测试。
BackgroundSome reports have suggested that infliximab may induce obstructive symptoms and, although there is no firm evidence, it is usually contraindicated in-patients with Crohn's disease (CD) and strictures.AimsTo evaluate the effect of infliximab on symptomatic strictures of the small intestine in CD and to identify predictive factors of clinical response.MethodsThis retrospective study included symptomatic patients treated with infliximab after conventional treatment had failed. The short-term (week 8) and long-term results were classified according to predefined criteria as complete, partial response, or failure.ResultsBefore infliximab, 18 patients had complete obstruction or intermittent chronic abdominal pain. Fourteen patients were treated by corticosteroids and 13 received immunosuppressive drugs. At week 8, complete, partial response and failure were observed in 10, 7 and 1 patients, respectively. Fourteen patients continued maintenance infliximab treatment after week 8. During the most recent evaluation (median follow-up: 18 months), 8 patients were on maintenance infliximab treatment; only eight were still on prednisone; there were five complete responses, 10 partial responses and three failures. Initiating prednisone or increasing its dosage was the only factor associated with a short-term complete response.ConclusionsInfliximab may be effective in patients with symptomatic strictures from CD, and should be tested before considering surgery.