Li Shi-rong, Sheng Jian-qiu, Li Shu-jun, Zhao Xiao-jun
Department of Gastrointestinal Medicine, Beijin Army General Hospital, Beijing, China.
Zhonghua Yi Xue Za Zhi. 2009 Sep 29;89(36):2568-70.
To explore the optimal therapeutic effect of infliximab (IFX) upon inflammatory bowel disease.
Eight patients with inflammatory bowel disease (IBD), including 5 Crohn's disease (CD) and 3 ulcerative colitis (UC), were treated with IFX of 5 mg/kg body weight at 0, 2 and 6 weeks, followed by scheduled maintenance therapy every 8 weeks and followed up for a long-term period. Of these patients, 5 cases were resistant to corticosteroid, 2 cases corticosteroid dependency and one naive patient.
All patients responded well to the scheduled program of 5 mg/kg infusion of IFX. Two CD cases achieved a complete remission. Two CD patients responded clinically; one was difficult to judge the result; of the UC patients, one achieved a complete remission and 2 responded. There were no serious side effects during the course of therapy.
Selecting the proper drug indications and therapeutic protocol, determining the doses and course of IFX on the basis of therapeutic response, combining IFX with other immunomodulators (esp. budesonide) and assessing the therapeutic efficacy of IFX by endoscopic mucosa healing rather than symptoms prevent disease recurrence and decrease side effects.
探讨英夫利昔单抗(IFX)治疗炎症性肠病的最佳疗效。
8例炎症性肠病(IBD)患者,其中5例克罗恩病(CD),3例溃疡性结肠炎(UC),在第0、2和6周接受5mg/kg体重的IFX治疗,随后每8周进行定期维持治疗并长期随访。这些患者中,5例对皮质类固醇耐药,2例皮质类固醇依赖,1例初治患者。
所有患者对5mg/kg输注IFX的既定方案反应良好。2例CD患者达到完全缓解。2例CD患者临床有反应;1例结果难以判断;UC患者中,1例达到完全缓解,2例有反应。治疗过程中无严重副作用。
选择合适的药物适应症和治疗方案,根据治疗反应确定IFX的剂量和疗程,将IFX与其他免疫调节剂(尤其是布地奈德)联合使用,并通过内镜下黏膜愈合而非症状评估IFX的治疗效果,可预防疾病复发并减少副作用。