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

1 Citation (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

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Abdominal Abscess
Risk Management
Crohn Disease
C-Reactive Protein
Abscess
Odds Ratio
Infliximab
Serum Albumin
Intestines
Blood Proteins
Multivariate Analysis
Logistic Models
Monoclonal Antibodies
Regression Analysis
Recurrence

Keywords

  • Abdominal abscess
  • Crohn's disease
  • Infliximab

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Yoneno, K., Hisamatsu, T., Matsuoka, K., Okamoto, S., Takayama, T., Ichikawa, R., ... 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

Risk and management of intra-abdominal abscess in crohn's disease treated with infliximab. / Yoneno, Kazuaki; Hisamatsu, Tadakazu; Matsuoka, Katsuyoshi; Okamoto, Susumu; Takayama, Tetsuro; Ichikawa, Riko; Sujino, Tomohisa; Miyoshi, Jun; Takabayashi, Kaoru; Mikami, Yohei; Mizuno, Shinta; Wada, Yasuyo; Yajima, Tomoharu; Naganuma, Makoto; Inoue, Nagamu; Iwao, Yasushi; Ogata, Haruhiko; Hasegawa, Hirotoshi; Kitagawa, Yuko; Hibi, Toshifumi; Kanai, Takanori.

In: Digestion, Vol. 89, No. 3, 2014, p. 201-208.

Research output: Contribution to journalArticle

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, Hibi, T & Kanai, T 2014, 'Risk and management of intra-abdominal abscess in crohn's disease treated with infliximab', Digestion, vol. 89, no. 3, pp. 201-208. https://doi.org/10.1159/000360618
Yoneno K, Hisamatsu T, Matsuoka K, Okamoto S, Takayama T, Ichikawa R et al. Risk and management of intra-abdominal abscess in crohn's disease treated with infliximab. Digestion. 2014;89(3):201-208. https://doi.org/10.1159/000360618
Yoneno, Kazuaki ; Hisamatsu, Tadakazu ; Matsuoka, Katsuyoshi ; Okamoto, Susumu ; Takayama, Tetsuro ; Ichikawa, Riko ; Sujino, Tomohisa ; Miyoshi, Jun ; Takabayashi, Kaoru ; Mikami, Yohei ; Mizuno, Shinta ; Wada, Yasuyo ; Yajima, Tomoharu ; Naganuma, Makoto ; Inoue, Nagamu ; Iwao, Yasushi ; Ogata, Haruhiko ; Hasegawa, Hirotoshi ; Kitagawa, Yuko ; Hibi, Toshifumi ; Kanai, Takanori. / Risk and management of intra-abdominal abscess in crohn's disease treated with infliximab. In: Digestion. 2014 ; Vol. 89, No. 3. pp. 201-208.
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AU - Yoneno, Kazuaki

AU - Hisamatsu, Tadakazu

AU - Matsuoka, Katsuyoshi

AU - Okamoto, Susumu

AU - Takayama, Tetsuro

AU - Ichikawa, Riko

AU - Sujino, Tomohisa

AU - Miyoshi, Jun

AU - Takabayashi, Kaoru

AU - Mikami, Yohei

AU - Mizuno, Shinta

AU - Wada, Yasuyo

AU - Yajima, Tomoharu

AU - Naganuma, Makoto

AU - Inoue, Nagamu

AU - Iwao, Yasushi

AU - Ogata, Haruhiko

AU - Hasegawa, Hirotoshi

AU - Kitagawa, Yuko

AU - Hibi, Toshifumi

AU - Kanai, Takanori

PY - 2014

Y1 - 2014

N2 - 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.

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KW - Abdominal abscess

KW - Crohn's disease

KW - Infliximab

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