Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan,
Surg Today. 2014 Feb;44(2):291-6. doi: 10.1007/s00595-013-0538-0. Epub 2013 Mar 6.
Preventing a recurrence of Crohn's disease is a problem that remains to be solved. We evaluated the impact of using infliximab as a postoperative therapy on preventing the surgical recurrence of Crohn's disease.
We performed a pair-matched study comparing 100 patients who had received postoperative infliximab maintenance therapy with those who had not between 1995 and 2010. The patients were matched by gender, Vienna classification and age at the time of the operation. Crohn's disease-related reoperation was evaluated as surgical recurrence.
In the postoperative infliximab maintenance therapy group, infliximab was administrated within 8 weeks after the operation. The median follow-up period was 36 months in the postoperative infliximab maintenance therapy group and 51 months in the control group. Surgical recurrences were recognized in 37 patients (three in the postoperative infliximab maintenance therapy group and 34 in the control group). A univariate analysis by the Kaplan-Meier method identified a body mass index >18 at the time of the operation (HR 0.19, p = 0.01) and postoperative infliximab maintenance therapy (HR 0.22, p = 0.0022) as factors related to the reduction of surgical recurrence. The multivariate analysis revealed that postoperative infliximab maintenance therapy was the only significant factor preventing surgical recurrence.
Postoperative infliximab maintenance therapy for Crohn's disease prevents surgical recurrence, at least within 3 years after the operation.
预防克罗恩病的复发仍然是一个待解决的问题。我们评估了术后使用英夫利昔单抗作为维持治疗对预防克罗恩病手术复发的影响。
我们进行了一项配对研究，比较了 1995 年至 2010 年期间接受术后英夫利昔单抗维持治疗的 100 例患者和未接受治疗的 100 例患者。通过性别、维也纳分类和手术时的年龄对患者进行配对。将与克罗恩病相关的再次手术评估为手术复发。
在术后英夫利昔单抗维持治疗组中，在术后 8 周内给予英夫利昔单抗。术后英夫利昔单抗维持治疗组的中位随访时间为 36 个月，对照组为 51 个月。在术后英夫利昔单抗维持治疗组中，有 37 例患者（术后英夫利昔单抗维持治疗组 3 例，对照组 34 例）发生手术复发。Kaplan-Meier 方法的单因素分析确定手术时的体重指数（BMI）>18（HR 0.19，p=0.01）和术后英夫利昔单抗维持治疗（HR 0.22，p=0.0022）是与降低手术复发相关的因素。多因素分析显示，术后英夫利昔单抗维持治疗是预防手术复发的唯一显著因素。
术后英夫利昔单抗治疗克罗恩病至少可在术后 3 年内预防手术复发。
