Chiba Mitsuro, Tsuji Tsuyotoshi, Nakane Kunio, Tsuda Satoko, Matsuzawa Hisanori, Sugawara Kae, Izumiya Yuki, Kimura Kazuya, Komatsu Masafumi, Tozawa Haruhiko
Division of Gastroenterology, Akita City Hospital, Akita City, Japan.
Division of Gastroenterology, Nakadori General Hospital, Akita City, Japan.
Transl Gastroenterol Hepatol. 2025 Jul 18;10:42. doi: 10.21037/tgh-24-162. eCollection 2025.
The new therapeutic modality incorporating a countermeasure against a westernized diet, i.e., a plant-based diet, showed far better outcomes than current standards in inflammatory bowel disease (IBD). Infliximab is widely used for induction and subsequent scheduled maintenance therapy in patients with IBD. However, the efficacy of infliximab diminishes over time. In the present study, we investigated the durability of scheduled infliximab maintenance therapy incorporating plant-based diet in IBD.
This was a prospective single-group trial at tertiary hospitals. Infliximab maintenance therapy was indicated in patients with severe disease or those who were unresponsive to conventional therapy. Infliximab (5 mg/kg body weight) was infused every 8 weeks on an inpatient basis, and plant-based diet, a lacto-ovo-vegetarian diet, was served three- or four-times during hospitalization. Patients were instructed to continue the diet after discharge. Durability was assessed using the Kaplan-Meier method.
Twenty-four patients [16 with Crohn's disease (CD), eight with ulcerative colitis (UC)] were included: median age 27.5 years old, disease duration 53.5 months, and concomitant use of immunosuppressant 21%. Intensification of infliximab was employed in 46% of patients. There was no significant difference in durability rates between CD and UC. Durability rates were 87% at both 5 and 10 years. Plant-based diet score in the median follow-up period of 9.3 years, which indicates adherence to the plant-based diet, was significantly higher than the baseline score.
Infliximab maintenance therapy incorporating plant-based diet yielded a high durability rate of 87% at 5 years in patients with IBD.
将针对西式饮食的对策（即植物性饮食）纳入其中的新治疗模式，在炎症性肠病（IBD）中显示出比当前标准更好的疗效。英夫利昔单抗广泛用于IBD患者的诱导治疗及后续的定期维持治疗。然而，英夫利昔单抗的疗效会随着时间推移而降低。在本研究中，我们调查了在IBD中采用植物性饮食的英夫利昔单抗定期维持治疗的持久性。
这是一项在三级医院进行的前瞻性单组试验。重度疾病患者或对传统治疗无反应的患者接受英夫利昔单抗维持治疗。英夫利昔单抗（5mg/kg体重）每8周住院输注一次，住院期间提供三或四次植物性饮食（一种蛋奶素食）。患者出院后被指导继续这种饮食。使用Kaplan-Meier方法评估持久性。
纳入了24例患者[16例克罗恩病（CD），8例溃疡性结肠炎（UC）]：中位年龄27.5岁，病程53.5个月，同时使用免疫抑制剂的比例为21%。46%的患者采用了英夫利昔单抗强化治疗。CD和UC之间的持久率无显著差异。5年和10年时的持久率均为87%。在中位随访期9.3年时，表明坚持植物性饮食的植物性饮食评分显著高于基线评分。
在IBD患者中，采用植物性饮食的英夫利昔单抗维持治疗在5年时产生了87%的高持久率。
