Dose optimization is effective in ulcerative colitis patients losing response to infliximab: A collaborative multicentre retrospective study

被引：37

作者：

Cesarini, Monica ^{[1
]}

Katsanos, Konstantinos ^{[2
]}

Papamichael, Konstantinos ^{[3
]}

Ellul, Pierre ^{[4
]}

Lakatos, Peter L. ^{[5
]}

Caprioli, Flavio ^{[6
,7
]}

Kopylov, Uri ^{[8
,9
]}

Tsianos, Epameinondas ^{[2
]}

Mantzaris, Gerassimos J. ^{[3
]}

Ben-Horin, Shomron ^{[8
,9
]}

Danese, Silvio ^{[10
]}

Fiorino, Gionata ^{[10
]}

机构：

[1] Sapienza Univ Rome, Rome, Italy

[2] Univ Ioannina, GR-45110 Ioannina, Greece

[3] Evangelismos Med Ctr, Dept Gastroenterol 1, Athens, Greece

[4] Mater Dei Hosp, Tal Qroqq, Malta

[5] Semmelweis Univ, Dept Med 1, H-1085 Budapest, Hungary

[6] Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy

[7] Osped Maggiore Policlin, IRCCS Ca Granda Fdn, Gastroenterol Unit 2, Milan, Italy

[8] Sheba Med Ctr, Dept Gastroenterol, Tel Hashomer, Israel

[9] Tel Aviv Univ, Sackler Sch Med, IL-69978 Tel Aviv, Israel

[10] IRCCS Humanitas, IBD Ctr, Via Manzoni 56, Milan, Italy

来源：

DIGESTIVE AND LIVER DISEASE | 2014年 / 46卷 / 02期

关键词：

Dose optimization; Infliximab; Loss of response; Ulcerative colitis; INFLAMMATORY-BOWEL-DISEASE; CROHNS-DISEASE; THERAPY; EFFICACY; OUTCOMES;

D O I：

10.1016/j.dld.2013.10.007

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Subjects maintained on infliximab scheduled therapy for inflammatory bowel disease may require dose optimization due to secondary loss of response. There are limited data on infliximab dose optimization for ulcerative colitis. Aims: To investigate dose optimization in ulcerative colitis patients with secondary loss of response. Methods: This was a retrospective multicentre study. Primary outcome was rapid clinical response assessed at the next administration of infliximab after dose intensification. Secondary outcomes were rapid clinical remission, and clinical response, remission and colectomy rate by week 52. Doubling the dose (10 mg/kg q8 weeks) vs. shortening the dose interval (5 mg/kg every 6 or 4 weeks) were compared. Results: Forty-one patients from eight centres were enrolled (15 for double dose and 26 for interval shortening). Rapid response was achieved in 37/41 patients (90.2%), while 19/41 (46.3%) achieved rapid clinical remission. At week 52, 28/41 patients were maintained in clinical remission, but 4 (9.8%) underwent colectomy. No difference was found between the two optimization strategies. Subjects achieving rapid clinical response had a significantly higher colectomy-free rate at week 52 (p = 0.002). Conclusion: Dose optimization of infliximab was effective to restore clinical response or remission and to prevent colectomy in ulcerative colitis patients with secondary loss of response. (C) 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

引用

页码：135 / 139

页数：5

共 21 条

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