Effect of timing of infliximab treatment on transmural healing of Crohn′s disease
10.3760/cma.j.cn101480-20220515-00070
- VernacularTitle:英夫利西单克隆抗体治疗时机对克罗恩病透壁愈合的影响
- Author:
Zicheng HUANG
1
;
Wenjie CHENG
;
Jian TANG
;
Si QIN
;
Zhuohua LIANG
;
Kang CHAO
;
Miao LI
;
Xiang GAO
;
Guangjian LIU
;
Qin GUO
Author Information
1. 中山大学附属第六医院消化内科，广州 510655
- Publication Type:Journal Article
- Keywords:
Crohn′s disease;
Intestinal ultrasound;
Transmural healing;
Infliximab;
Early therapy
- From:
Chinese Journal of Inflammatory Bowel Diseases
2022;06(4):312-316
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of timing of infliximab (IFX) treatment on transmural healing (TH) in Crohn′s disease (CD) .Methods:A retrospective cohort study was conducted. Consecutive adult patients with active CD prescribed IFX in the Sixth Affiliated Hospital of Sun Yat-sen University from Janurary to September 2019 were recruited. Patients underwent intestinal ultrasound evaluation at baseline and 14 weeks after IFX initiation. According to the time from diagnosis to IFX initiation, patients were divided into early therapy group (≤12 months) and late therapy group (>12 months) . The differences of transmural healing (TH) and mucosal healing (MH) at 14th week between 2 groups were analyzed. TH was defined as bowel wall thickness (BWT) ≤3 mm in any segments, with normal stratification and bowel wall vascularity, and without mesenteric fat proliferation. MH was defined as the simplified endoscopic score for CD≤2 points and without ulceration.Results:Fifty-four patients were enrolled, including 28 in early therapy group and 26 in late therapy group, and there were no significant differences in baseline BWT[6.0 (5.3, 7.0) mm vs. 7.0 (5.0, 8.0) mm, Z = -0.668, P = 0.504] and simplified endoscopic score for CD[ (12.86 ± 9.26) points vs. (12.89 ± 7.46) points, t = -0.012, P = 0.991] between the two group. At 14th week, the decrease of BWT [3.0 (1.3, 3.0) mm vs. 1.0 (0, 2.0) mm, Z = -2.922, P = 0.003], the rate of TH [39.3% (11/28) vs. 11.5% (3/26) , χ 2 = 5.405, P = 0.020] and MH [52.2% (12/23) vs. 20.8% (5/24) , χ 2 = 4.997, P = 0.025] in early therapy group were significantly higher than those in late therapy group, respectively. Conclusion:Compared with late initiation of IFX treatment after diagnosis, patients with CD who initiate IFX treatment earlier are more likely to achieve TH.
