Kinoshita Hiroto, Kunisaki Reiko, Yamamoto Hisae, Matsuda Reikei, Sasaki Tomohiko, Kimura Hideaki, Tanaka Katsuaki, Naganuma Makoto, Maeda Shin
Inflammatory Bowel Disease Centre, Yokohama City University Medical Centre, Japan.
Intern Med. 2013;52(17):1855-62. doi: 10.2169/internalmedicine.52.0589.
To investigate the short- and long-term efficacy and safety of infliximab (IFX) in intestinal Behçet's disease (BD) patients in a retrospective cohort study.
Among 43 consecutive patients with intestinal BD presenting at the same clinic, 15 with active disease and receiving standard treatment were given IFX infusions (5 mg/kg body weight) every eight weeks. The patients were clinically and endoscopically evaluated before treatment, then assessed after 10 weeks, 12 months and 24 months for a clinical response, defined as a significant improvement in intestinal symptoms and a reduced C-reactive protein (CRP) level.
At week 10, 12 patients (80%) exhibited a response to IFX, with eight (53%) in remission with no intestinal symptoms and normal CRP levels. A response to IFX was maintained in seven of the 11 patients (64%) available at 12 months and in four of the eight patients (50%) available at 24 months. Of the seven patients receiving prednisolone at entry, five responders had their steroid doses reduced. Fulminant intestinal BD was predictive of an absence of response to IFX. The adverse effects comprised one infusion reaction and one case of fever, most likely related to IFX.
IFX is effective and safe in patients with refractory intestinal BD.
在一项回顾性队列研究中，调查英夫利昔单抗（IFX）治疗肠道白塞病（BD）患者的短期和长期疗效及安全性。
在同一诊所连续就诊的43例肠道BD患者中，15例患有活动性疾病且接受标准治疗的患者每8周接受一次IFX输注（5mg/kg体重）。在治疗前对患者进行临床和内镜评估，然后在10周、12个月和24个月后评估临床反应，临床反应定义为肠道症状显著改善和C反应蛋白（CRP）水平降低。
在第10周时，12例患者（80%）对IFX有反应，其中8例（53%）缓解，无肠道症状且CRP水平正常。在12个月时可评估的11例患者中有7例（64%）维持了对IFX的反应，在24个月时可评估的8例患者中有4例（50%）维持了反应。在入组时接受泼尼松龙治疗的7例患者中，5例有反应者的类固醇剂量减少。暴发性肠道BD预示着对IFX无反应。不良反应包括1例输注反应和1例发热，最可能与IFX有关。
IFX治疗难治性肠道BD患者有效且安全。
