Efficacy And Safety Of Infliximab In The Treatment Of Moderate To Severe Ulcerative Colitis

Objective:At present,the incidence of ulcerative colitis(UC)in China has inc reased year by year,and some patients have poor efficacy with traditional med icine.This study was designed to evaluate the efficacy and safety of infliximab(IFX)in the treatment of moderate to severe ulcerative colitis.Methods:We retrospectively analyzed the efficacy and safety of 21 patients wi th moderate to severe ulcerative colitis treated with infliximab.The 21 patients were admitted to the Department of Gastroenterology in the First Affiliated Ho spital of China Medical University from January,2010 to December,2018.At th e 0th,2nd,and 6th week,the patients were given an induction infusion of 5mg/kg IFX intravenously,and then intravenously instilled once every 8 weeks f or maintenance treatment,and anti-allergic drug like dexamethasone was routine ly administered before instillation.The clinical data of patients before and after treatment were collected:1.Serological indicators such as hemoglobin,serum al bumin,platelet count,C-reactive protein,and erythrocyte sedimentation rate bef ore application of IFX,6 weeks after administration,and 30 weeks after admin istration;2.Results of fiberoptic colonoscopy before and after IFX treatment;3.Recovery of extraintestinal performance after 30 weeks of treatment with IFX;4.Adverse reactions that occur during the treatment of IFX.The data were anal yzed by SPSS 22.0 statistical software.P<0.05 was considered statistically signi ficant.Results:Twenty-one patients with refractory UC were treated with IFX for 6 weeks,and 19 patients were clinically effective.Clinical symptoms such as abdominal pain,mucus pus and blood,and fever were significantly relieved,and C-reactive protein,erythrocyte sedimentation rate,and platelet count were significantly decreased(P<0.05),while hemoglobin and serum albumin were significantly increased(P<0.05),and 2 patient had a primary non-response.One patient was treated with IFX for 14 weeks.The clinical symptoms were not significantly relieved and the inflammatory index was not significantly decreased.After the drug was stopped,the fecal transplantwas performed.Nine patients were treated with IFX for 30 weeks.Clinical symptoms such as abdominal pain,mucus pus and blood,and fever were significantly relieved.Mayo score,C-reactive protein,erythrocyte sedimentation rate,and platelet count were significantly decreased(P<0.05),while hemoglobin and serum white were observed.The protein was significantly elevated(P<0.05).Three patients with peripheral arthritis and one patient with gangrenous pyoderma were all relieved to varying degrees.There were 5 adverse reactions in the 21 patients with refractory UC who were treated with IFX.One patient developed Epstein-Barr virus infection after 6weeks of treatment.After stopping the drug and giving antiviral therapy to the disease,the relevant tests showed no replication of the virus,and the drug regimen was adjusted to a combination of hormone and immunosuppressive therapy.Four patients developed different degrees of allergic reaction in the first application of IFX treatment,which showed rash,dyspnea,blood pressure,etc.The above symptoms were relieved after intravenous administration of the hormone,and continued to slowly IFX treatment the next day.After the patient did not have an allergic reaction.Conclusion:IFX is effective in the treatment of patients with moderate to severe UC,with fewer recent adverse reactions and higher overall safety.