Gastroenterology Unit, Epidemiology Section, Herlev University Hospital, Copenhagen, Denmark.
Aliment Pharmacol Ther. 2012 Nov;36(9):840-9. doi: 10.1111/apt.12043.
Infliximab (IFX) maintenance therapy for Crohn's disease (CD) is administered every 8 weeks, but inter-patient variation in optimal treatment intervals may exist.
To assess, in a prospective pilot study, the efficacy, safety and quality of life (QoL) of IFX maintenance treatment scheduled through web-based self-monitoring of disease activity.
Twenty-seven CD patients in IFX maintenance therapy were enrolled and received a standardised disease education and web-training. Using the http://www.cd.constant-care.dk concept, patients recorded their disease activity and faecal calprotectin weekly. From this, the inflammatory burden (IB) score was calculated, placing patients in the green, yellow or red zones of a ‘traffic light’ system. If placed in the yellow or red zones, the computer directed these patients to consult their physician for IFX infusion.
Seventeen patients (63%) completed 52 weeks of follow-up, 6 (22%) completed 26 weeks and 4 (15%) were excluded due to loss of response, patient decision or non-adherence. In total, 121 IFX infusions were given with a median interval of 9 (range: 4–18) weeks. Only 10% of infusions were given at 8-week intervals, whereas 39% were administered with shorter and 50% with longer intervals respectively. The mean IB and the QoL remained stable during the web-treatment. One mild infusion reaction and one case of folliculitis were observed, while three patients underwent surgery.
The program http://www.cd.constant-care.dk appears to be a practical and safe concept for the individualised scheduling of maintenance treatment with IFX in patients with Crohn's disease. Larger studies are awaited to confirm this preliminary outcome.
英夫利昔单抗（IFX）用于克罗恩病（CD）的维持治疗每 8 周进行一次，但患者之间的最佳治疗间隔可能存在差异。
在一项前瞻性试点研究中评估通过基于网络的疾病活动自我监测来安排 IFX 维持治疗的疗效、安全性和生活质量（QoL）。
27 例接受 IFX 维持治疗的 CD 患者入组，并接受标准化疾病教育和网络培训。使用 http://www.cd.constant-care.dk 概念，患者每周记录疾病活动和粪便钙卫蛋白。根据这些数据，计算炎症负担（IB）评分，将患者置于“红绿灯”系统的绿色、黄色或红色区域。如果处于黄色或红色区域，计算机将指导这些患者咨询医生进行 IFX 输注。
17 例患者（63%）完成了 52 周的随访，6 例（22%）完成了 26 周的随访，4 例（15%）因失去反应、患者决定或不依从而被排除。共进行了 121 次 IFX 输注，中位数间隔为 9 周（范围：4-18 周）。只有 10%的输注在 8 周间隔进行，而 39%的输注间隔较短，50%的输注间隔较长。在网络治疗期间，平均 IB 和 QoL 保持稳定。观察到 1 例轻度输注反应和 1 例滤泡炎病例，3 例患者接受了手术。
http://www.cd.constant-care.dk 方案似乎是一种实用且安全的概念，可用于个体化安排克罗恩病患者的 IFX 维持治疗。需要更大的研究来证实这一初步结果。
