Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
Aliment Pharmacol Ther. 2010 Nov;32(9):1129-34. doi: 10.1111/j.1365-2036.2010.04446.x. Epub 2010 Aug 30.
Tumour necrosis factor-blockade with infliximab has advanced the treatment of Crohn's disease. While infliximab is efficacious, it remains to be determined whether patients who enter clinical remission with an anti-tumour necrosis factor therapy can have their treatment stopped and retain the state of remission.
To assess in patients with Crohn's disease who obtained infliximab-induced remission, the proportion who relapsed after infliximab discontinuation.
This longitudinal cohort study examined patients from a University-based IBD referral centre. Forty eight patients with Crohn's disease in full clinical remission and who then discontinued infliximab were followed up for up to 7 years. Crohn's disease relapse was defined as an intervention with Crohn's disease medication or surgery.
Kaplan-Meier analysis of the proportion of patients with sustained clinical benefit demonstrated that 50% relapsed within 477 days after infliximab discontinuance. In contrast, 35% of patients remained well, and without clinical relapse, up to the end of the nearly 7-year follow-up.
In patients with Crohn's disease with an infliximab-induced remission, stopping infliximab results in a predictable relapse in a majority of patients. Nevertheless, a small percentage of patients sustain a long-term remission.
英夫利昔单抗的肿瘤坏死因子阻断治疗推进了克罗恩病的治疗。虽然英夫利昔单抗有效，但仍需确定接受抗肿瘤坏死因子治疗后进入临床缓解的患者是否可以停止治疗并保持缓解状态。
评估在接受英夫利昔单抗诱导缓解的克罗恩病患者中，停止英夫利昔单抗治疗后复发的比例。
本纵向队列研究检查了来自大学炎症性肠病转诊中心的患者。48 例克罗恩病患者达到完全临床缓解，然后停用英夫利昔单抗，随访长达 7 年。克罗恩病复发定义为使用克罗恩病药物或手术进行干预。
Kaplan-Meier 分析显示，在停止英夫利昔单抗后 477 天内，持续临床获益的患者比例为 50%复发。相比之下，35%的患者在近 7 年的随访结束时仍然良好，没有临床复发。
在接受英夫利昔单抗诱导缓解的克罗恩病患者中，停止英夫利昔单抗治疗后，大多数患者会出现可预测的复发。然而，仍有一小部分患者能长期缓解。
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