Long-Term Outcomes of Infliximab Treatment in 582 Korean Patients with Crohn's Disease: A Hospital-Based Cohort Study

作者：Park Sang Hyoung; Hwang Sung Wook; Kwak Min Seob; Kim Wan Soo; Lee Jeong Mi; Lee Ho Su; Yang Dong Hoon; Kim Kyung Jo; Ye Byong Duk; Byeon Jeong Sik; Myung Seung Jae; Yoon Yong Sik; Yu Chang Sik; Kim Jin Ho; Yang Suk Kyun^*

来源：Digestive Diseases and Sciences, 2016, 61(7): 2060-2067.

DOI：10.1007/s10620-016-4105-6

• Crohn's disease
• Infliximab
• Outcome
• Korea

To date, no large-scale studies have evaluated long-term outcomes of infliximab (IFX) treatment in Korean patients with Crohn's disease (CD).
We analyzed long-term clinical responses to IFX in 582 Korean CD patients who received scheduled IFX treatments at Asan Medical Center. Clinical responses were defined as maintaining IFX without major abdominal surgery (MAS) or dose intensification.
Between February 2002 and July 2015, a total of 11,990 IFX infusions were administered to 582 Korean patients with CD over a median period of 36 months. At the end of follow-up, 316 (54.3 %) were still receiving IFX without MAS (71 patients, 12.2 %) or dose intensification (86 patients, 14.8 %). IFX was stopped in 109 (18.7 %) patients because of a loss of response (48 patients, 8.2 %), adverse events (30 patients, 5.2 %), or patient preferences or problems with reimbursement (31 patients, 5.3 %). The cumulative survival for maintenance of IFX without MAS or dose intensification was 89.0, 75.9, 68.3, and 50.8 % at 1, 2, 3, and 5 years, respectively. Multivariate regression analysis identified older age at the initiation of IFX (a parts per thousand yen40 years, P = 0.006) and a longer disease duration (a parts per thousand yen3 years, P = 0.020) as independent positive predictors of a poorer response to IFX.
The long-term efficacy of IFX in a large, real-life cohort of Korean patients with CD appears to be similar to that in previously published Western studies. Our findings support the early use of IFX to obtain better clinical outcomes.

• 出版日期2016-7