Zou Jun, Ji Da-Nian, Cai Jian-Fei, Guan Jian-Long, Bao Zhi-Jun
Department of Immunology and Rheumatology, Huadong Hospital, Fudan University, No. 221 West Yan'an Road, Shanghai, 200040, China.
Center of Gastrointestinal Endoscopy, Huadong Hospital, Fudan University, Shanghai, China.
Dig Dis Sci. 2017 Feb;62(2):441-447. doi: 10.1007/s10620-016-4395-8. Epub 2017 Jan 2.
Intestinal Behcet's disease (BD) is a specific subtype of BD. Effective drug therapy for intestinal BD remains elusive.
To investigate long-term outcomes and identify predictors of sustained response in intestinal BD patients receiving infliximab (IFX) treatment.
The medical records were reviewed of patients received IFX from September 2012 to March 2016. The cumulative probabilities of sustained response were calculated using the Kaplan-Meier. Predictor factors for sustained response were accessed by receiver operating characteristic curve.
Totally, 27 active intestinal BD patients were enrolled. Sustained responses were observed in 17 patients, after a median follow-up duration 24 months (interquartile range 9-37). The proportion of clinical remission at week 14, 30, and 52 had occurred in 84.6, 70, and 70%, respectively, with the proportion of clinical remission of 69.2, 40, and 55%. The mucosal healing (MH) rate at week 14 was 72%. Kaplan-Meier estimated patients with achievement of clinical and biological responses at week 14 or MH was likely to remain sustained clinical response. ROC curve analysis revealed CRP level (of 6.85 mg/L) at week 14 is a potential predictor for discriminating patients with sustained response from relapse, with an area under the curve values of 0.837.
IFX is effective and safe for induction and maintenance therapy in Chinese patients with moderate-to-severe active intestinal BD. Early achievement of clinical response and mucosal healing might associate long-term response. A lower CRP level seems to be associated with a more benign clinical course.
肠道白塞病（BD）是BD的一种特殊亚型。针对肠道BD的有效药物治疗仍然难以捉摸。
研究接受英夫利昔单抗（IFX）治疗的肠道BD患者的长期预后，并确定持续缓解的预测因素。
回顾性分析2012年9月至2016年3月接受IFX治疗的患者的病历。使用Kaplan-Meier法计算持续缓解的累积概率。通过受试者工作特征曲线评估持续缓解的预测因素。
共纳入27例活动期肠道BD患者。17例患者观察到持续缓解，中位随访时间为24个月（四分位间距9-37）。第14周、30周和52周的临床缓解率分别为84.6%、70%和70%，临床缓解比例分别为69.2%、40%和55%。第14周的黏膜愈合（MH）率为72%。Kaplan-Meier法估计，在第14周实现临床和生物学缓解或MH的患者可能保持持续临床缓解。ROC曲线分析显示，第14周的CRP水平（6.85mg/L）是区分持续缓解患者与复发患者的潜在预测因素，曲线下面积值为0.837。
IFX对中国中重度活动期肠道BD患者的诱导和维持治疗有效且安全。早期实现临床缓解和黏膜愈合可能与长期缓解相关。较低的CRP水平似乎与更良性的临床病程相关。
