Russo E A, Harris A W, Campbell S, Lindsay J, Hart A, Arebi N, Milestone A, Tsai H H, Walters J, Carpani M, Westaby D, Thillainayagam A, Bansi D, Ghosh S
Imperial College Healthcare NHS Trust, London, UK.
Aliment Pharmacol Ther. 2009 Feb 1;29(3):308-14. doi: 10.1111/j.1365-2036.2008.03890.x. Epub 2008 Nov 13.
Infliximab is used for treatment of Crohn's disease and, following the Active Ulcerative Colitis Trials (ACT) 1 and 2, it has been used as rescue and maintenance therapy in moderate and severe ulcerative colitis (UC).
To report on English experience with maintenance infliximab in terms of response and colectomy rates and side-effect profile in UC.
A retrospective audit conducted by using a web-based questionnaire filled in by 12 gastroenterologists from six English centres.
Of the 38 patients receiving induction with infliximab, 28 (73.6%) maintained an ongoing response (8-weekly infusions 5 mg/kg) for a mean duration of 16.8 months (range 4-59), with 21 (55.3%) being in remission. Three of 38 patients (7.9%) who also responded had a secondary loss of response after an average of 10 months (range 8-13); seven of 38 patients (18.4%) showed no response. The colectomy rate was seven of 38 (18.4%, five non-responders and two with secondary loss of response). Adverse effects occurred in five patients (13.2%). Two discontinued infliximab (alopecia, invasive breast cancer). The three less-severe adverse effects were acute and delayed-type hypersensitivity reactions and one persistent otitis media.
Our experience suggests acceptable response rates, colectomy rates and side-effect profile of maintenance therapy with infliximab in moderate and severe UC.
英夫利昔单抗用于治疗克罗恩病，并且在1期和2期活动性溃疡性结肠炎试验（ACT）之后，它已被用作中重度溃疡性结肠炎（UC）的挽救和维持治疗。
报告英夫利昔单抗维持治疗在UC中的反应、结肠切除术率和副作用方面的英国经验。
通过由来自六个英国中心的12位胃肠病学家填写的基于网络的问卷进行回顾性审计。
在38例接受英夫利昔单抗诱导治疗的患者中，28例（73.6%）维持持续反应（每8周输注5mg/kg），平均持续时间为16.8个月（范围4 - 59个月），其中21例（55.3%）处于缓解期。38例中另外3例（7.9%）有反应的患者在平均10个月（范围8 - 13个月）后出现继发性反应丧失；38例中有7例（18.4%）无反应。结肠切除术率为38例中的7例（18.4%，5例无反应者和2例有继发性反应丧失者）。5例患者（13.2%）出现不良反应。2例停用英夫利昔单抗（脱发、浸润性乳腺癌）。另外3例不太严重的不良反应为急性和迟发型超敏反应以及1例持续性中耳炎。
我们的经验表明，英夫利昔单抗在中重度UC维持治疗中的反应率、结肠切除术率和副作用情况是可以接受的。
