Effectiveness and influencing factors of infliximab in the treatment of Crohn's disease
Objective To evaluate the effectiveness and influencing factors of infliximab(IFX)in the treatment of Crohn's disease(CD).Methods A total of 375 patients with CD who were treated with IFX at Shanghai Tenth People's Hospital Affiliated to Tongji University during January 1,2018 to July 1,2022 were retrospectively included.Baseline data before IFX treatment and follow-up data at the 54th week of treatment were collected,including age,gender,disease duration,Montreal classification,surgery history,drug history,height,weight,Crohn's disease activity score(CDAI),and simplified Crohn's Disease Endoscopic score(SES-CD).Chi-square test and single factor and multiple factor analysis were applied to analyze the key factors affecting the effectiveness of IFX in the treatment of CD.Results Of 375 patients with CD,352 were treated with IFX and 23 were treated with IFX after ileostomy.Of the 352 patients with CD,72.7％achieved clinical response(△CDAI≥70),61.4％achieved clinical remission(CDAI＜150)at week 54,56.3％achieved endoscopic response(△SES-CD≥50％),and 37.6％achieved endoscopic remission(SES-CD≤2).Of the 23 patients with CD after ileostomy,4.3％achieved endoscopic remission(Rutgeert score＜i2).Patients with short disease duration better responded to IFX proved by higher clinical response(P=0.001),endoscopic response(P=0.036),and endoscopic remission(P=0.032).Patients without perianal CD achieved higher clinical response rate(P=0.006).Patients with lower erythrocyte sedimentation rate and elevated C-reactive protein at baseline achieved higher clinical remission(P=0.001)and endoscopic remission(P=0.02),respectively.The clinical remission rate and endoscopic response rate of B1 type CD were higher(P=0.003),and the endoscopic response rate of L2 type was higher than that of L1 type CD(P=0.02).Conclusion CD patients with short disease duration,non-perianal,B1 type and L2 type have better response to IFX treatment.
Crohn's diseaseAnti-tumor necrosis factor a monoclonal antibodyInfliximabPerianal Crohn's diseaseClinical effectiveness
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