第十章 JGastroenlogy 类克谷浓度内镜活动规范治疗.pdf

J Gastroenterol DOI 10.1007/s00535-013-0829-7 ORIGINAL ARTICLE—ALIMENTARY TRACT Relationship between serum infliximab trough levels and endoscopic activities in patients with Crohn’s disease under scheduled maintenance treatment Hirotsugu Imaeda • Shigeki Bamba • Kenichiro Takahashi • Takehide Fujimoto • Hiromitsu Ban • Tomoyuki Tsujikawa • Masaya Sasaki • Yoshihide Fujiyama • Akira Andoh Received: 19 March 2013 / Accepted: 25 April 2013 Springer Japan 2013 Abstract trough levels for identifying normal laboratory markers was Background and aims Few data are available to support 0.6 lg/ml for CRP, 1.0 lg/ml for serum albumin and the clinical relevance of infliximab (IFX) trough levels for 1.1 lg/ml for fecal calprotectin. Identification of mucosal prediction of endoscopic disease activity in Crohn’s disease healing needed a higher cutoff value of 4.0 lg/ml. Thiopu- (CD). This study evaluated the endoscopic disease activities rine treatment did not affect IFX trough and ATI levels. in relation to clinical outcome using several laboratory Conclusion Mucosal healing requires higher IFX trough markers including serum IFX trough levels in patients with levels, compared to those to achieve normalization of CD undergoing scheduled IFX maintenance treatment. routine clinical markers. Materials and methods A total of 78 sessions of endos- copy were performed on 45 patients with CD. Endoscopic Keywords Anti-infliximab antibodies Mucosal healing activity was assessed using the modified Rutgeerts scoring Receiver operation curve system. IFX trough levels and anti-IFX antibodies (ATIs) were determined by immunoassays. Results Endoscopic activity negatively cor