Efficiency and safety analysis of early application of Infliximab combined with azathiopurine in the treatment of Crohn's disease

TIAN Feng; XIE Ying; YAN Bo

doi:10.19538/j.nk2017030114

Abstract：Objective To explore the efficiency and safety of early application of IFX combined with AZA in the treatment of Crohn's disease with more than 2 poor prognostic factors.Methods Clinical data of 18 patients,who were diagnosed with CD with more than 2 poor prognostic factors and received early combined treatment of IFX and AZA from March 2013 to June 2015,was retrospectively analyzed.Laboratory indexes,Best-CDAI,SES-CD,rate of fistula closure and adverse effects were observed and compared before treatment and at 14th and 30th week after the beginning of treatment.Results Among the 18 CD patients,who have received 14 weeks of treatment,9 received 30 weeks of treatment.Compared with that before treatment,at the 14th week the average BestCDAI,SES-CD,ESR and CRP decreased obviously(P＜0.05);Hct,ALB,BMI all rose (P＜0.05).Compared with that at the 14th week,at the 30th week,the average BestCDAI and SES-CD continued to improve obviously(P＜0.05);BMI further increased(P＜0.05).The rates of clinical remission of the 14th and 30th week were 83.3％ and 88.9％;the rates of endoscopic mucosal healing were 11.1％ and 55.6％.Among the 6 CD patients who were complicated with fistula,2 patients completed 30 weeks of treatment.At the time of 14th week,the rate of complete healing was G while the rate of partial healing was 100％.The fistulas of the two CD patients who had finished 30-week-treatment were healed.During the period of observation,2 of the 18 patients had transient hepatic dysfunction in the 2nd week;3 had a drop of WBC count in the 6th week,but recovered soon after being given relative treatment without affecting further treatment.However,no adverse event of drug-related infection or malignancy has been observed during follow-up till now.Conclusion Early combined treatment of IFX and AZA can improve the clinical symptom and control whole body inflammory reaction of CD patients with more than 2 poor prognostic factors;continuous treatment can induce and maintain the remission of disease efficiently,promote the endo-copic healing of intestinal mucosa and the healing of fistulas.The incidence of adverse effect hasn't been increased significantly.