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英夫利昔单抗可延长克罗恩病患者首次手术前的病程。

Infliximab extends the duration until the first surgery in patients with Crohn's disease.

作者信息

Sakatani Aki, Fujiya Mikihiro, Ito Takahiro, Inaba Yuhei, Ueno Nobuhiro, Kashima Shin, Tominaga Motoya, Moriichi Kentaro, Okamoto Kotaro, Tanabe Hiroki, Ikuta Katsuya, Ohtake Takaaki, Kono Toru, Furukawa Hiroyuki, Ashida Toshifumi, Kohgo Yutaka

机构信息

Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.

Division of Gastroenterological and General Surgery, Department of Surgery, Asahikawa Medical University, 2-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.

出版信息

Biomed Res Int. 2013;2013:879491. doi: 10.1155/2013/879491. Epub 2013 Nov 26.

Abstract

BACKGROUND/AIMS: While biological drugs are useful for relieving the disease activity and preventing abdominal surgery in patients with Crohn's disease (CD), it is unclear whether the use of biological drugs in CD patients with no history of abdominal surgery is appropriate. We evaluated the effects of infliximab and other factors on extending the duration until the first surgery in CD patients on a long-term basis.

METHODS

The clinical records of 104 CD patients were retrospectively investigated. The cumulative nonoperation rate until the first surgery was examined with regard to demographic factors and treatments.

RESULTS

The 50% nonoperative interval in the 104 CD patients was 107 months. The results of a univariate analysis revealed that a female gender, the colitis type of CD, and the administration of corticosteroids, immunomodulators, or infliximab were factors estimated to improve the cumulative nonoperative rate. A multivariate analysis showed that the colitis type and administration of infliximab were independent factors associated with a prolonged interval until the first surgery in the CD patients with no history of abdominal surgery.

CONCLUSIONS

This study suggests that infliximab treatment extends the duration until the first surgery in CD patients with no history of abdominal surgery. The early use of infliximab before a patient undergoes abdominal surgery is therefore appropriate.

摘要

背景/目的:虽然生物药物有助于缓解克罗恩病(CD)患者的疾病活动并预防腹部手术,但在无腹部手术史的CD患者中使用生物药物是否合适尚不清楚。我们长期评估了英夫利昔单抗及其他因素对延长CD患者首次手术时间的影响。

方法

回顾性调查了104例CD患者的临床记录。针对人口统计学因素和治疗方法,检查了直至首次手术的累积非手术率。

结果

104例CD患者的50%非手术间隔时间为107个月。单因素分析结果显示,女性、CD的结肠炎类型以及使用皮质类固醇、免疫调节剂或英夫利昔单抗是估计可提高累积非手术率的因素。多因素分析表明,结肠炎类型和英夫利昔单抗的使用是与无腹部手术史的CD患者首次手术间隔时间延长相关的独立因素。

结论

本研究表明,英夫利昔单抗治疗可延长无腹部手术史的CD患者首次手术的时间。因此,在患者接受腹部手术前尽早使用英夫利昔单抗是合适的。

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