Jakobovits S L, Jewell D P, Travis S P L
John Radcliffe Hospital, Oxford, UK.
Aliment Pharmacol Ther. 2007 May 1;25(9):1055-60. doi: 10.1111/j.1365-2036.2007.03300.x.
Infliximab has been shown to be of benefit in the treatment of ulcerative colitis but long-term colectomy rates remain unknown.
To review the rate of colectomy after infliximab for ulcerative colitis and to identify factors that might predict the need for colectomy.
We conducted a retrospective cohort study of patients with active ulcerative colitis treated with infliximab between 2000 and 2006. The primary outcome was colectomy-free survival. Disease and treatment characteristics and complications were documented.
Thirty patients were treated with infliximab for refractory ulcerative colitis. Sixteen (53%) came to colectomy a median of 140 days after their first infusion (range 4-607). There was no difference in colectomy between those receiving infliximab for acute severe ulcerative colitis failing intravenous steroids (8/14) and out-patients with steroid-refractory ulcerative colitis (8/16). Only 17% (5/30) achieved a steroid-free remission after a median follow-up of 13 months (range 2-72). Univariate analysis showed that a younger age at diagnosis of colitis was significantly associated with an increased rate of colectomy (27.5 years vs. 38.7 years, P = 0.016).
Over half the patients studied came to colectomy. Of those avoiding colectomy, only five (17%) sustained a steroid-free remission.
英夫利昔单抗已被证明对溃疡性结肠炎的治疗有益，但长期结肠切除术的发生率仍不清楚。
回顾英夫利昔单抗治疗溃疡性结肠炎后的结肠切除术发生率，并确定可能预测结肠切除术需求的因素。
我们对2000年至2006年间接受英夫利昔单抗治疗的活动性溃疡性结肠炎患者进行了一项回顾性队列研究。主要结局是无结肠切除术生存率。记录疾病和治疗特征及并发症。
30例患者接受英夫利昔单抗治疗难治性溃疡性结肠炎。16例（53%）在首次输注后中位140天（范围4 - 607天）接受了结肠切除术。因静脉用类固醇治疗失败的急性重症溃疡性结肠炎患者（8/14）和类固醇难治性溃疡性结肠炎门诊患者（8/16）之间的结肠切除术发生率无差异。中位随访13个月（范围2 - 72个月）后，只有17%（5/30）实现了无类固醇缓解。单因素分析显示，结肠炎诊断时年龄较小与结肠切除术发生率增加显著相关（27.5岁对38.7岁，P = 0.016）。
超过一半的研究患者接受了结肠切除术。在避免结肠切除术的患者中，只有5例（17%）维持了无类固醇缓解。
