Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Guangdong Provincial Key Laboratory of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
Scand J Gastroenterol. 2021 Jul;56(7):812-819. doi: 10.1080/00365521.2021.1922748. Epub 2021 May 7.
The efficacy of infliximab in treatment-naïve patients with stricturing small bowel Crohn's disease (CD) has not been well studied. We aimed to evaluate the efficacy of infliximab in these patients.
This was a retrospective study of all consecutive treatment-naïve patients with newly diagnosed CD with small bowel stricture who started regular infliximab therapy in Nanfang Hospital between January 2015 and December 2019. An effective infliximab therapy was defined as infliximab continuation without the use of steroids, new biologics, endoscopic interventions or intestinal surgery.
Seventy-nine patients were included. After a median 38 months follow-up, an effective infliximab therapy was achieved in 37 patients. Long diagnostic delay (hazard ratio [HR] 0.38, 95% confidence interval [CI] 0.19-0.78; = .008), pre-stenotic dilatation (HR 0.17, 95%CI 0.09-0.35; < .001), long segmental stricture (HR 0.20, 95%CI 0.10-0.41; < .001), and penetrating disease (HR 0.22, 95%CI 0.10-0.49; < .001) were negatively correlated with an effective infliximab therapy.
Infliximab is effective in nearly 50% of treatment-naïve patients with CD with small bowel stricture, and an effective therapy is more likely to be achieved in patients without long diagnostic delay, pre-stenotic dilatation, long segmental stricture or penetrating disease.
尚未接受过治疗的狭窄型小肠克罗恩病（CD）患者使用英夫利昔单抗的疗效尚未得到充分研究。我们旨在评估英夫利昔单抗在这些患者中的疗效。
这是一项回顾性研究，纳入了 2015 年 1 月至 2019 年 12 月期间在南方医院接受定期英夫利昔单抗治疗的新诊断为 CD 且伴有小肠狭窄的初治患者。有效的英夫利昔单抗治疗定义为在不使用类固醇、新型生物制剂、内镜介入或肠手术的情况下继续使用英夫利昔单抗。
共纳入 79 例患者。中位随访 38 个月后，37 例患者实现了有效的英夫利昔单抗治疗。较长的诊断延迟（风险比 [HR] 0.38，95%置信区间 [CI] 0.19-0.78；= 0.008）、狭窄前扩张（HR 0.17，95%CI 0.09-0.35； < 0.001）、长节段狭窄（HR 0.20，95%CI 0.10-0.41； < 0.001）和穿透性疾病（HR 0.22，95%CI 0.10-0.49； < 0.001）与有效的英夫利昔单抗治疗呈负相关。
英夫利昔单抗在近 50%的初治伴有小肠狭窄的 CD 患者中有效，在没有较长诊断延迟、狭窄前扩张、长节段狭窄或穿透性疾病的患者中更有可能实现有效的治疗。
