Efficacy analysis of infliximab treatment in inducing and maintaining deep remission in 26 patients with moderate to severe Crohn's disease / 中华消化杂志

ABSTRACT

Objective To explore the efficacy and safety of infliximab (IFX) treatment in inducing and maintaining deep remission (DR) in patients with moderate to severe Crohn's disease (CD).Methods From February 2012 to April 2014,the clinical data of 26 patients with moderate to severe CD received IFX treatment were retrospectively analyzed.Laboratory indexes (erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),albumin),Crohn's disease activity index (CDAI),Crohn's disease simplified endoscopic score (SES-CD),rate of DR and side effects were observed before treatment,at week 14 and week 30.The t test was performed for normal distribution measurement data comparison between two groups.Wilcoxon signed rank test was performed for non normal distribution measurement data comparison between two groups.Chi square test and Fisher exact probability method were used for rate comparison.Results In 26 patients with CD,at week 14,the CDAI significantly decreased compared with that before treatment (225.0(124.0,265.0) vs 80.0(67.0,124.7),Z=-4.265,P＜0.01); ESR and CRP levels also significantly decreased while body mass index (BMI) and albumin levels increased.The rate of clinical remission,mucosal healing under endoscope and DR was 80.0 ％ (21/26),42.3 ％ (11/ 26) and 34.6％ (9/26),respectively.The rate of clinical remission was higher in patients with the disease course less than one year (92.3％ vs 69.2％,P=0.32).At week 30,the CDAI of patients significantly decreased compared with that before treatment (225.0(124.0,265.0) vs 81.5(67.0,111.0),Z=-4.877,P＜0.01); the ESR and CRP levels significantly decreased; while the BMI and albumin levels increased.The rate of clinical remission,mucosal healing under endoscope and DR was 88.5 ％ (23/26),57.7％(15/26) and 53.8％ (14/26),respectively.Rate of clinical remission was higher in patients with the disease course less than one year (100.0％ vs 76.9％,P=0.22).The differences in the rates of clinical remission,mucosal healing and DR between week 14 and week 30 were not statistically significant.Conclusion IFX could induce and maintain DR in patients with moderate to severe CD.