Efficacy Of Infliximab On Crohn’s Disease Patients In Fujian Province

Objective:To investigate the effects of TNF-a antibody Infliximab（IFX）on Crohn’s disease（CD）patients in Fujian Province.Methods:Two hundred and seventy-three CD patients from Fujian Province were retrospectively enrolled in this study,then divided into Group IFX and Group non-IFX according to their therapy strategy.The patients in Group IFX were subdivided into Group IFX monotherapy（Group Mon-IFX）and Group IFX combined with AZA or MTX（Group Com-IFX）.The clinical remission rate,serology remission rate,endoscopic remission rate at the 14^th week,the 1^st year and the 2^ed year,and the surgical rate during the 2 follow-up years were calculated respectively.Results:（1）The 273 patients who conformed with the diagnosis standard of CD from the Fujian IBD Center,the First Affiliated Hospital of Fujian Medical University were included in this study,then divided into Group IFX（n=170）and Group non-IFX（n=103）.The patients in Group IFX were subdivided into Group IFX monotherapy（Group Mon-IFX,n=68）and Group IFX combined with AZA or MTX（Group Com-IFX,n=103）.There was no significant difference in baseline characteristics among the groups.（2）At 14^th week,clinical remission rate was>75%in Group IFX and 50-75%in Group non-IFX.At the 1^st year,clinical remission rates were both>75%in the two groups,and mucosal healing rates were 40.9%in Group IFX and 38.0%in Group non-IFX,the difference showing no statistical significance（P>0.05）.At the 2^ed year,the clinical remission rates were both>75%in the two groups,and mucosal healing rates were 38.7%in Group IFX and 51.7%in Group non-IFX（P>0.05）.The surgical rates during the 2 years were 2.9%in Group IFX and11.7%in Group non-IFX respectively（P<0.01）.（3）The clinical remission rates in Group Mon-IFX and in Group Com-IFX were all more than 75%at the 14^th week,the1^st year and the 2^ed year respectively.The mucosal healing rates at the 1^st year were44.7%in Group Mon-IFX and 38.8%in Group Com-IFX,and 43.5%and 36.5%at the2^ed year respectively.The 2-year duration surgical rates were 2.9%in Group Mon-IFX and 2.9%in Group Com-IFX.All the differences between the two groups had no significance.（P<0.05）.（4）Multivariate Logistic regression analysis showed that the OR of disease behaviour type B3 was 5.780（95%CI 1.633-20.454）and the OR of serum ALB level was 0.893（95%CI 0.812-0.981）（P<0.05）.It means that type B3and low serum ALB level are independent risk factors for surgery.Conclusion:IFX can quickly relieve the clinical symptoms and reduce the surgical rate in CD patients.However,IFX seems to have no more advantage in mucosal healing compared with traditional treatments.