Caviglia Renato, Ribolsi Mentore, Rizzi Marina, Emerenziani Sara, Annunziata Maria Laura, Cicala Michele
University Campus Bio-Medico, Department of Digestive Disease, Via E Longoni, Rome, Italy.
World J Gastroenterol. 2007 Oct 21;13(39):5238-44. doi: 10.3748/wjg.v13.i39.5238.
To evaluate the safety and efficacy of a long-term therapy with infliximab in Crohn's disease (CD) and ulcerative colitis (UC) patients retrospectively.
The medical charts of 50 patients (40 CD and 10 UC), who received after a loading dose of 3 infliximab infusions scheduled re-treatments every 8 wk as a maintenance protocol, were reviewed.
Median (range) duration of treatment was 27 (4-64) mo in CD patients and 24.5 (6-46) mo in UC patients. Overall, 32 (80%) CD and 9 (90%) UC patients showed a sustained clinical response or remission throughout the maintenance period. Three CD patients shortened the interval between infusions. Eight (20%) CD patients and 1 UC patient underwent surgery for flare up of disease. Nine out of 29 CD and 4 out of 9 UC patients, who discontinued infliximab scheduled treatment, are still relapse-free after a median of 16 (5-30) and 6.5 (4-16) mo following the last infusion, respectively. Ten CD patients (25%) and 1 UC patient required concomitant steroid therapy during maintenance period, compared to 30 (75%) and 9 (90%) patients at enrollment. Of the 50 patients, 16 (32%) experienced at least 1 adverse event and 3 patients (6%) were diagnosed with cancer during maintenance treatment.
Scheduled infliximab strategy is effective in maintaining long-term clinical remission both in CD and UC and determines a marked steroid sparing effect. Long-lasting remission was observed following infliximab withdrawal.
回顾性评估英夫利昔单抗长期治疗克罗恩病（CD）和溃疡性结肠炎（UC）患者的安全性和有效性。
回顾了50例患者（40例CD和10例UC）的病历，这些患者在接受3次英夫利昔单抗负荷剂量输注后，按照维持方案每8周进行一次定期再治疗。
CD患者的中位（范围）治疗持续时间为27（4 - 64）个月，UC患者为24.5（6 - 46）个月。总体而言，32例（80%）CD患者和9例（90%）UC患者在整个维持期表现出持续的临床反应或缓解。3例CD患者缩短了输注间隔。8例（20%）CD患者和1例UC患者因疾病发作接受了手术。在29例停止英夫利昔单抗定期治疗的CD患者中，9例，9例UC患者中的4例，在最后一次输注后的中位时间分别为16（5 - 30）个月和6.5（4 - 16）个月后仍未复发。10例CD患者（25%）和1例UC患者在维持期需要同时接受类固醇治疗，而在入组时分别为30例（75%）和9例（90%）患者。在50例患者中，16例（32%）至少经历了1次不良事件，3例患者（6%）在维持治疗期间被诊断出患有癌症。
定期英夫利昔单抗治疗策略在维持CD和UC的长期临床缓解方面有效，并具有显著的类固醇节省作用。在停用英夫利昔单抗后观察到持久缓解。
