Ghent University Hospital, Gent, Belgium.
J Crohns Colitis. 2012 Jun;6(5):557-62. doi: 10.1016/j.crohns.2011.11.002. Epub 2011 Dec 11.
To evaluate the effect of infliximab induction therapy on calprotectin levels in patients with ulcerative colitis (UC).
In this prospective study 53 patients with active UC from 17 centers were treated with infliximab therapy (5 mg/kg) at baseline, week 2, and week 6. Faecal calprotectin was measured every week. Sigmoidoscopies were performed at baseline, week 6 and week 10.
Median calprotectin levels decreased from 1260 (IQR 278.5- 3418) at baseline to 72.5 (IQR 18.5 - 463) at week 10 (p<0.001). After 10 weeks, infliximab therapy induced endoscopic remission and a decrease in calprotectin to<50 mg/kg or at least a 80% decrease from baseline level in 58% of patients. A significant and steep decrease of calprotectin levels was seen at week 2 for patients with an endoscopic remission at week 10 as compared to patients who did not show a remission. (p<0.001). At week 10 an excellent correlation was found between endoscopic remission and clinical Mayo score reflected by an AUC of ROC analyses of 0.94 (0.87-1) and with calprotectin measurements (AUC 0.91 (0.81-1)) : all patients with calprotectin levels <50 mg/kg, and a normal clinical Mayo score (=0) were in endoscopic remission.
Infliximab induces a fast and significant decrease of faecal calprotectin levels in anti-TNF naïve patients with ulcerative colitis predictive for remission of disease.
评估英夫利昔单抗诱导治疗对溃疡性结肠炎（UC）患者钙卫蛋白水平的影响。
本前瞻性研究纳入了来自 17 个中心的 53 名活动性 UC 患者，他们在基线、第 2 周和第 6 周接受英夫利昔单抗治疗（5mg/kg）。每周测量粪便钙卫蛋白。在基线、第 6 周和第 10 周进行乙状结肠镜检查。
中位数钙卫蛋白水平从基线时的 1260（IQR 278.5-3418）降至第 10 周时的 72.5（IQR 18.5-463）（p<0.001）。10 周后，英夫利昔单抗治疗诱导内镜缓解和钙卫蛋白降低至<50mg/kg，或与基线相比至少降低 80%，在 58%的患者中达到。与未缓解的患者相比，第 10 周内镜缓解的患者在第 2 周钙卫蛋白水平有显著且陡峭的下降（p<0.001）。第 10 周时，内镜缓解与临床 Mayo 评分之间存在极好的相关性，ROC 分析的 AUC 为 0.94（0.87-1），与钙卫蛋白测量的相关性为 0.91（0.81-1）：所有钙卫蛋白水平<50mg/kg 且临床 Mayo 评分正常（=0）的患者均处于内镜缓解状态。
英夫利昔单抗可诱导抗 TNF 初治溃疡性结肠炎患者粪便钙卫蛋白水平快速且显著降低，对疾病缓解具有预测作用。
