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Predictors of infliximab-induced deep remission in treatment-naïve patients with isolated small bowel Crohn’s disease

英夫利昔单抗 医学 胃肠病学 内科学 克罗恩病 优势比 炎症性肠病 逻辑回归 胶囊内镜 疾病 回顾性队列研究 外科
作者
Zemin Han,Bingxia Chen,Qian Zhou,Hongbin Liu,Pei-chun Xu,Fachao Zhi
出处
期刊:Scandinavian Journal of Gastroenterology [Taylor & Francis]
卷期号:56 (12): 1422-1426 被引量:1
标识
DOI:10.1080/00365521.2021.1971759
摘要

Deep remission should be induced early in the disease course of Crohn's disease (CD), because it significantly prevents disease progression. Identifying predictors of deep remission before treatment is important to guide therapeutic strategy. Little is known about the predictors of infliximab-induced deep remission in treatment-naïve patients with isolated small bowel CD. We aimed to investigate the predictors of infliximab-induced deep remission in these patients.From January 2015 to December 2019, all consecutive treatment-naïve patients with isolated small bowel CD who started infliximab induction therapy (5 mg/kg at week 0, 2, and 6) and underwent capsule endoscopy (CE) at week 14 were retrospectively included. Deep remission was defined as clinical remission in combination with CE-identified mucosal healing. Logistic regression was used to investigate the predictors of 14-week deep remission.Ninety-one patients were included. At week 14 after infliximab induction therapy, deep remission was found in 42 patients. Multivariate logistic regression analysis showed that a moderate-to-severe endoscopic disease [odds ratio (OR), 0.28; p = .01] and the presence of fibrofatty proliferation (OR, 0.26; p = .04) at baseline were independently associated with a decreased possibility of deep remission.In treatment-naïve patients with isolated small bowel CD, a moderate-to-severe endoscopic disease and the presence of fibrofatty proliferation at baseline reduce the possibility of infliximab-induced deep remission. Patients with such risk factors may need more aggressive treatment at the beginning of induction therapy to promote deep remission at an early stage.
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