Risk and management of intra-abdominal abscess in crohn's disease treated with infliximab

Kazuaki Yoneno, Tadakazu Hisamatsu, Katsuyoshi Matsuoka, Susumu Okamoto, Tetsuro Takayama, Riko Ichikawa, Tomohisa Sujino, Jun Miyoshi, Kaoru Takabayashi, Yohei Mikami, Shinta Mizuno, Yasuyo Wada, Tomoharu Yajima, Makoto Naganuma, Nagamu Inoue, Yasushi Iwao, Haruhiko Ogata, Hirotoshi Hasegawa, Yuko Kitagawa, Toshifumi HibiTakanori Kanai

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and Aims: Infliximab (IFX) is a monoclonal antibody used to treat patients with Crohn's disease (CD). Intra-abdominal abscess formation is a major complication of CD with negative effects on patient prognosis. We have analyzed risk factors for abscess formation in CD patients treated with IFX. Methods: CD patients who received IFX between January 2000 and April 2011 at Keio University Hospital were analyzed retrospectively. Risk factors for abscess formation were assessed by univariate and multivariate logistic regression analyses. Results: Intra-abdominal abscess was seen in 15 of 258 patients. Univariate analyses showed serum C-reactive protein (CRP) concentration at 14 weeks after initiation of IFX (p = 0.021), serum albumin concentration at week 0 (p = 0.022) and week 14 (p = 0.004), the presence of anal lesions (p = 0.036), progression of intestine deformation (p = 0.015) and early loss of response to IFX (p < 0.0001) to be risk factors. Multivariate analysis showed that CRP concentration at 14 weeks [odds ratio (OR) 1.361] and loss of IFX response within 6 months (OR 5.361) were independent risk factors. Conclusions: Abscess formation should be suspected in patients with symptoms of CD recurrence during IFX therapy. Uncontrolled CRP concentration and early loss of response to IFX are risk factors.

Original languageEnglish
Pages (from-to)201-208
Number of pages8
JournalDigestion
Volume89
Issue number3
DOIs
Publication statusPublished - 2014 Jun

Keywords

  • Abdominal abscess
  • Crohn's disease
  • Infliximab

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Risk and management of intra-abdominal abscess in crohn's disease treated with infliximab'. Together they form a unique fingerprint.

  • Cite this

    Yoneno, K., Hisamatsu, T., Matsuoka, K., Okamoto, S., Takayama, T., Ichikawa, R., Sujino, T., Miyoshi, J., Takabayashi, K., Mikami, Y., Mizuno, S., Wada, Y., Yajima, T., Naganuma, M., Inoue, N., Iwao, Y., Ogata, H., Hasegawa, H., Kitagawa, Y., ... Kanai, T. (2014). Risk and management of intra-abdominal abscess in crohn's disease treated with infliximab. Digestion, 89(3), 201-208. https://doi.org/10.1159/000360618