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英夫利昔单抗治疗激素难治性溃疡性结肠炎的短期和长期结局及相关预后因素:一项单中心回顾性研究

Short- and Long-Term Outcomes of Infliximab Treatment for Steroid-Refractory Ulcerative Colitis and Related Prognostic Factors: A Single-Center Retrospective Study.

作者信息

Nasuno Masanao, Miyakawa Maki, Tanaka Hiroki, Motoya Satoshi

机构信息

IBD Center, Sapporo-Kosei General Hospital, Sapporo, Japan.

出版信息

Digestion. 2017;95(1):67-71. doi: 10.1159/000452459. Epub 2017 Jan 5.

DOI:10.1159/000452459
PMID:28052276
Abstract

BACKGROUND/AIMS: The aim of this study was to analyze the short- and long-term outcomes of infliximab (IFX) treatment to cure steroid-refractory ulcerative colitis (UC) and related prognostic factors.

METHODS

Retrospective data were collected from 125 patients with steroid-refractory UC who received IFX treatment at our center from July 2005 to November 2013. The Lichtiger clinical activity index score was calculated at baseline, 2 weeks, 6 weeks, and 1 year, and the cumulative non-colectomy rate following IFX administration was estimated. Remission rate prognostic factors and the cumulative colectomy rate prognostic factors were evaluated using multivariate logistic regression analysis and multivariate Cox regression analysis, respectively.

RESULTS

Remission rates at 2 weeks, 6 weeks, and 1 year were 46, 58, and 45%, respectively. The 1-, 3-, and 5-year cumulative non-colectomy rates were 80, 78, and 75%, respectively. Previous treatment with calcineurin inhibitors was a significant prognostic factor for lower remission and cumulative non-colectomy rates, whereas concomitant immunomodulators was a significant prognostic factor for the higher remission rate. Gender (female) was a prognostic factor for higher remission rate at 1 year and higher cumulative non-colectomy rate.

CONCLUSIONS

This study revealed good short- and long-term outcomes of IFX treatment in patients with steroid-refractory UC. Previous treatment with calcineurin inhibitors was a prognostic factor for poor outcomes of IFX treatment, whereas concomitant immunomodulators and gender (female) were prognostic factors for good outcomes.

摘要

背景/目的:本研究旨在分析英夫利昔单抗(IFX)治疗激素难治性溃疡性结肠炎(UC)的短期和长期疗效及相关预后因素。

方法

回顾性收集2005年7月至2013年11月在本中心接受IFX治疗的125例激素难治性UC患者的数据。在基线、2周、6周和1年时计算Lichtiger临床活动指数评分,并估算IFX给药后的累计非结肠切除术率。分别采用多因素逻辑回归分析和多因素Cox回归分析评估缓解率预后因素和累计结肠切除术率预后因素。

结果

2周、6周和1年时的缓解率分别为46%、58%和45%。1年、3年和5年的累计非结肠切除术率分别为80%、78%和75%。既往使用钙调神经磷酸酶抑制剂治疗是缓解率和累计非结肠切除术率降低的显著预后因素,而同时使用免疫调节剂是缓解率升高的显著预后因素。性别(女性)是1年时缓解率较高和累计非结肠切除术率较高的预后因素。

结论

本研究显示IFX治疗激素难治性UC患者具有良好的短期和长期疗效。既往使用钙调神经磷酸酶抑制剂治疗是IFX治疗效果不佳的预后因素,而同时使用免疫调节剂和性别(女性)是治疗效果良好的预后因素。

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