Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Gastroenterology, University of Michigan, 6520C MSRB I, SPC 5682, 1150 W Medical Center Dr, Ann Arbor, MI, 48109, USA.
BMC Gastroenterol. 2022 Mar 28;22(1):149. doi: 10.1186/s12876-022-02221-0.
Behçet's disease (BD) is a recurrent multisystem inflammatory disease. Anti-tumor necrosis factor (TNF) α agents have been used to treat patients with intestinal BD with severe disease activity or those who are resistant to conventional treatments; however, the long-term efficacy of anti-TNFα agents in intestinal BD remains unclear. In the present study, we investigated the clinical outcomes and predictors of discontinuation of anti-TNFα agents in patients with intestinal BD.
We reviewed the medical records of patients with intestinal BD who received first-line anti-TNFα agents between January 2009 and June 2020. The primary outcome was the percentage of patients who continued anti-TNFα therapy for 48 weeks. Secondary outcomes included the percentage of patients who achieved marked improvement, complete remission, and mucosal healing, as well as predictors of discontinuation of anti-TNFα agents.
A total of 29 patients were included in the study. Twenty-two (75.9%) patients continued anti-TNFα therapy for 48 weeks. The percentage of patients who achieved marked improvement, complete remission, and mucosal healing at week 48 was 48.3%, 37.9%, and 48.3%, respectively. At week 96, 11 (37.9%) patients achieved marked improvement, complete remission, and mucosal healing. A higher C-reactive protein level (CRP; ≥ 1 mg/dL) at baseline was a predictor of discontinuation of anti-TNFα agents.
The 48-week continuation rate of anti-TNFα agents was 75.9% in bio-naïve patients with intestinal BD. However, a higher baseline CRP level (≥ 1 mg/dL) was associated with discontinuation of anti-TNFα agents.
白塞病（BD）是一种反复发作的多系统炎症性疾病。抗肿瘤坏死因子（TNF）α 制剂已被用于治疗有严重疾病活动或对常规治疗有抵抗的肠 BD 患者；然而，抗 TNFα 制剂在肠 BD 中的长期疗效仍不清楚。在本研究中，我们研究了肠 BD 患者使用抗 TNFα 制剂的临床结局和停药预测因素。
我们回顾了 2009 年 1 月至 2020 年 6 月期间接受一线抗 TNFα 制剂治疗的肠 BD 患者的病历。主要结局是继续抗 TNFα 治疗 48 周的患者比例。次要结局包括达到显著改善、完全缓解和黏膜愈合的患者比例，以及抗 TNFα 制剂停药的预测因素。
共纳入 29 例患者。22 例（75.9%）患者继续抗 TNFα 治疗 48 周。48 周时达到显著改善、完全缓解和黏膜愈合的患者比例分别为 48.3%、37.9%和 48.3%。96 周时，11 例（37.9%）患者达到显著改善、完全缓解和黏膜愈合。基线时 C 反应蛋白（CRP）水平较高（≥1mg/dL）是抗 TNFα 制剂停药的预测因素。
在肠 BD 的生物初治患者中，抗 TNFα 制剂的 48 周续用率为 75.9%。然而，较高的基线 CRP 水平（≥1mg/dL）与抗 TNFα 制剂停药相关。
