Analysis Of The Efficacy Of Short-term Scheduled Infliximab Therapy On Active Crohn’s Disease

ObjectiveThrough a retrospective study to evaluate the efficacy of short-term scheduled infliximab(IFX) therapy on active Crohn’s diease(CD) in China, and make a try to explore the ideal course of the maintain treatment of the IFX.Methods64 patients with active CD who were from Sir Run Run Shaw Hospital affiliated of Zhejiang University accepted infliximab therapy from March 2012 to December 2014were collected. Infliximab induction was administered at weeks 0,2, and 6 and maintenance therapy at 8-week intervals (5mg/Kg Xian Janssen Pharmaceutical Ltd.) at least 6 times (30weeks).All patients began to combine azathioprine (AZA) at week 2.①The rate of clinical remission, deep remission,mucosal healing and blood indexes were assessed at the 30th weeks.②The CD who reached the standard of mucosal healing (SES-CD<2)at the 30th weeks were collected and be divided into two groups according to whether to continue using IFX:Group A (continue using IFX); Group B (stop using IFX);then the rate of mucosal healing, operation and adverse events were assessed at the 54th weeks.Results①Of the 64CD patients,55(85.9%)were in clinical remission,48(75%)in mucosal healing and 42(65.6%) in deep remission after a scheduled 30weeks(6 times)of infliximab therapy. ② The results of observing in patients with mucosal healing at 54th weeks in two groups were statistically significant. In Group A,16/20(80%)were still in mucosal healing compared to 6/15(40%) in Group B (P<0.05);In addition, in Group A, 2/20(10%) with abdominal pain and diarrhea, compared to 8/15(53.3%) with abdominal discomfort in Group B (P<0.05).In Group A, one patient had bowel resection, one patient had bowel resection identically in Group B, there were no differences in the rate of operation between the two groups. In Group A, two patients had adverse events, one of whom had knee pain and the other had leukopenia. While in Group B, only one had leukopenia. There were no differences in the rate of the adverse events between the two groups.Conclusion①Application the short-term duration(6 times) of scheduled infliximab therapy to the active CD in China can achieve the higher rate of deep remission and clinical remission.② Observing in patients with mucosal healing at 54th weeks, the rate of mucosal healing in Group A (continue using IFX) is much higher than Group B (stop using IFX);and the rate of recurrence in Group A is lower than Group B, the rate of the adverse events between the two groups were no differences. Extending the course of maintenance treatment appropriately can improve the mucosal remission rate and reduce the recurrence rate effectively. And that will not increase the incidence of adverse events.