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英夫利昔单抗在诱导和维持肠道白塞病缓解中的疗效。

Efficacy of infliximab for induction and maintenance of remission in intestinal Behçet's disease.

作者信息

Naganuma Makoto, Sakuraba Atsushi, Hisamatsu Tadakazu, Ochiai Hiroki, Hasegawa Hirotoshi, Ogata Haruhiko, Iwao Yasushi, Hibi Toshifumi

机构信息

Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Inflamm Bowel Dis. 2008 Sep;14(9):1259-64. doi: 10.1002/ibd.20457.

Abstract

BACKGROUND

Intestinal Behçet disease (BD) is characterized by intestinal inflammation with round and oval ulcers associated with gastrointestinal symptoms. Although several cases have been reported that infliximab is effective for induction of remission, the efficacy of infliximab for maintaining remission is unknown.

METHODS

Six cases with fulminant intestinal BD were treated with infliximab. All patients were steroid-dependent and refractory to immunosuppressants; 3 patients were treated with 6-mercaptopurine, 1 patient with azathioprine, 1 patient with cyclosporine A, and 1 patient with methotrexate.

RESULTS

Four patients achieved remission by infliximab and all of these patients maintained remission with scheduled treatments of infliximab, with the longest duration of remission being about 3 years. Another 2 patients with ileal ulceration required surgery; however, 1 patient has maintained remission by scheduled treatment of infliximab for 2 years after surgery.

CONCLUSIONS

Infliximab appears to offer an option for fulminant intestinal BD to induce and maintain remission, although a randomized control trial is needed.

摘要

背景

肠道白塞病(BD)的特征是肠道炎症伴圆形和椭圆形溃疡,并伴有胃肠道症状。尽管已有数例报告显示英夫利昔单抗对诱导缓解有效,但英夫利昔单抗维持缓解的疗效尚不清楚。

方法

6例暴发性肠道BD患者接受了英夫利昔单抗治疗。所有患者均依赖类固醇且对免疫抑制剂耐药;3例患者接受了6-巯基嘌呤治疗,1例接受硫唑嘌呤治疗,1例接受环孢素A治疗,1例接受甲氨蝶呤治疗。

结果

4例患者通过英夫利昔单抗实现缓解,所有这些患者通过定期使用英夫利昔单抗治疗维持缓解,缓解最长持续时间约为3年。另外2例回肠溃疡患者需要手术治疗;然而,1例患者术后通过定期使用英夫利昔单抗治疗维持缓解2年。

结论

英夫利昔单抗似乎为暴发性肠道BD诱导和维持缓解提供了一种选择,尽管还需要进行随机对照试验。

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