当前位置： SCI文献检索 > DIGESTIVE DISEASES AND SCIENCES期刊下所有文献 > Infliximab Dose Escalation as an Effective Strategy for Managing Secondary Loss of Response in Ulcerative Colitis.

Infliximab Dose Escalation as an Effective Strategy for Managing Secondary Loss of Response in Ulcerative Colitis.

Abstract：

BACKGROUND:The outcomes of infliximab dose escalation in ulcerative colitis (UC) have not been well evaluated. AIMS:To assess the short- and long-term outcomes of infliximab dose escalation in a cohort of patients with UC. METHODS:This was a multicenter, retrospective, cohort study. All consecutive UC patients who had lost response to infliximab maintenance infusions and who underwent infliximab dose escalation were included. Post-escalation short-term clinical response and remission were evaluated. In the long term, the cumulative probabilities of infliximab failure-free survival and colectomy-free survival were calculated. Predictors of short-term response and event-free survival were estimated using logistic regression analysis and Cox proportional hazard regression analysis. RESULTS:Seventy-nine patients were included. Fifty-four patients (68.4%) achieved short-term clinical response and 41 patients (51.9%) entered in clinical remission. After a median follow-up of 15 months [interquartile range (IQR) 8-26], 33 patients (41.8%) had infliximab failure. Patients with short-term response had a significantly lower adjusted rate of infliximab failure [hazard ratio (HR) 0.24, 95% confidence interval (CI) 0.12-0.49; p < 0.001]. During a median follow-up of 24 months (IQR 13-34), 9 patients (11.4%) needed colectomy. Short-term response was identified as a predictor of colectomy avoidance (HR 0.14; 95% CI 0.03-0.69; p < 0.007). CONCLUSIONS:In UC patients who lost response to infliximab during maintenance, infliximab dose escalation enabled recovery of short-term response in nearly 70% of patients. In the long term, 58% of patients maintained sustained clinical benefit, and 9 of 10 avoided colectomy. Short-term response was associated with an 86% reduction in the relative risk of colectomy.

journal_name

Dig Dis Sci

journal_title

Digestive diseases and sciences

authors

Taxonera C,Barreiro-de Acosta M,Calvo M,Saro C,Bastida G,Martín-Arranz MD,Gisbert JP,García-Sánchez V,Marín-Jiménez I,Bermejo F,Chaparro M,Ponferrada Á,Martínez-Montiel MP,Pajares R,de Gracia C,Olivares D,Alba C,Mendoza

doi

10.1007/s10620-015-3735-4

subject

Has Abstract

pub_date

2015-10-01 00:00:00

pages

3075-84

issue

eissn

0163-2116

issn

1573-2568

pii

10.1007/s10620-015-3735-4

journal_volume

pub_type

杂志文章,多中心研究

在线工具

Infliximab Dose Escalation as an Effective Strategy for Managing Secondary Loss of Response in Ulcerative Colitis.