Long-term efficacy of infliximab maintenance therapy for perianal Crohn’s disease

作     者：Motoi Uchino Hiroki Ikeuchi Toshihiro Bando Hiroki Matsuoka Yoshio Takesue Yoshiko Takahashi Takayuki Matsumoto Naohiro Tomita 

作者机构：Departments of Lower Gastroenterological SurgeryHyogo College of Medicine Infection Control and PreventionHyogo College of Medicine Department of Internal MedicineDivision of Lower GastroenterologyHyogo College of Medicine 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2011年第17卷第9期

页      面：1174-1179页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：手术治疗 单抗 疗效 临床反应 复发率 累积率 患者 狭窄 

摘      要：AIM:To assess the long-term efficacy of seton drainage with infliximab maintenance therapy in treatment of stricture for perianal Crohn’s disease(CD). METHODS:Sixty-two patients with perianal CD who required surgical treatment with or without infliximab between September 2000 and April 2010 were identified from our clinic’s *** activities of the perianal lesions were evaluated using the modified perianal CD activity index(mPDAI)*** primary endpoint was a clinical response at 12-15 wk after surgery as a shortterm *** endpoints were recurrence as reflected in the mPDAI score,defined as increased points in every major *** clinical responses were classified as completely healed(mPDAI=0),partially improved(mPDAI score decreased more than 4 points),and failure or recurrence(mPDAI score increased or decreased less than 3 points). RESULTS:There were 43 males and 19 females,of whom 26 were consecutively treated with infliximab after surgery as maintenance *** healing was not *** was seen in 10/36(27.8%) patients without infliximab and 4/26(15.4%)patients with infliximab(P=0.25).Partial improvement was seen in 26/36(72.2%)patients without infliximab and 22/26(88.5%)patients with infliximab(P=0.25). Short-term improvement was achieved in 48/62(77.4%) *** the mPDAI score improved significantly with surgery regardless of infliximab,it decreased more from baseline in patients with infliximab(50.0%) than in those without infliximab(28.6%),(P=0.003). In the long-term,recurrence rates were low regardless of infliximab in patients without anorectal *** patients with anorectal stricture,cumulative recurrence incidences increased gradually and exceeded 40%at 5 years regardless of *** efficacy of infliximab treatment was found(P=0.97).Although the cumulative rate of ostomy creation was also low in patients without stricture and high in patients with stricture,no protective efficacy was found wit