Abstract:
BACKGROUND:Adalimumab (ADA) is a subcutaneous anti-tumour necrosis factor (anti-TNF) agent, effective in inducing and maintaining remission in Crohn's disease (CD). Unlike Infliximab (IFX), ADA dosing is not weight adjusted and dose frequency is based on clinical response. AIM:To determine whether obesity is a risk factor for early loss of response (LOR) to anti-TNF treatment and whether weight-adjusted anti-TNF treatment is favourable. MATERIALS AND METHODS:A hospital database of CD patients receiving anti-TNF treatment was analyzed retrospectively. The relationship between time to LOR and BMI was examined by Kaplan-Meier (KM) survival curves and a Cox proportional hazards model. RESULTS:ADA patients: Of the 54 patients (46 BMI<30 and 8 BMI≥30), KM estimation indicated a significantly shorter time to dose escalation in the BMI of at least 30 (χ=6.117, P=0.01). The Cox proportional hazards model showed that an increased hazard of LOR to ADA is related to increases in BMI (P=0.04). IFX patients: Of the 76 patients (62 BMI<30 and 14 BMI≥30), KM estimation showed that the differences in survival curves were not significant (χ=1.933, P=0.16) for the BMI groups. This was supported by the Cox proportional hazard model (P=0.36). CONCLUSION:BMI appears to be important in predicting ADA efficacy (LOR) in CD. IFX appears to overcome this reduction of efficacy in obese patients. A prospective study evaluating the effect of weight on anti-TNF drug response and serum drug levels is warranted.
journal_name
Eur J Gastroenterol Hepatoljournal_title
European journal of gastroenterology & hepatologyauthors
Bhalme M,Sharma A,Keld R,Willert R,Campbell Sdoi
10.1097/MEG.0b013e32835d1f15subject
Has Abstractpub_date
2013-05-01 00:00:00pages
543-9issue
5eissn
0954-691Xissn
1473-5687journal_volume
25pub_type
杂志文章abstract:BACKGROUND AND AIMS:The occurrence of hepatic encephalopathy is one of the main factors limiting the development and application of transjugular intrahepatic portosystemic shunt (TIPS). Our study aimed to verify the efficacy of the albumin-bilirubin score, an objective and simple scoring system, to predict post-TIPS he...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0000000000001801
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abstract::End-stage liver disease and its related complications exert a huge disease burden and reduce the survival rates of many patients. Albumin administration for patients with decompensated liver cirrhosis has been a controversial topic of discussion. The aim of this study is to investigate whether albumin reduces the mort...
journal_title:European journal of gastroenterology & hepatology
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journal_title:European journal of gastroenterology & hepatology
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journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0b013e3282f4aa01
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journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/MEG.0b013e328348c0bf
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abstract::Amyloidosis is a group of disorders that can manifest in virtually any organ system in the body and is thought to be secondary to misfolding of extracellular proteins with subsequent deposition in tissues. The precursor protein that is produced in excess defines the specific amyloid type. This requires histopathologic...
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journal_title:European journal of gastroenterology & hepatology
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journal_title:European journal of gastroenterology & hepatology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:European journal of gastroenterology & hepatology
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journal_title:European journal of gastroenterology & hepatology
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journal_title:European journal of gastroenterology & hepatology
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journal_title:European journal of gastroenterology & hepatology
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更新日期:2017-03-01 00:00:00