期刊
GASTROENTEROLOGY
卷 143, 期 2, 页码 356-+出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.gastro.2012.04.043
关键词
Basiliximab; Randomized Clinical Trial; IBD; Immune Response
资金
- Cerimon Pharmaceuticals
- Novartis Pharmaceuticals (manufacturer of basiliximab)
- Janssen Biotech
- Pfizer
- Abbott
- Imedex
- GlaxoSmithKline
- Amgen
- Prometheus Laboratories
- Elan Pharmaceuticals
- Astellas
- Bristol-Myers Squibb
- Bracco
- Diagnostics
- Creative Educational Concepts, Inc
- Curatio CME Institute/Axis Healthcare Communications
- Dyax
- Emmi Solutions
- Immune Pharmaceuticals Corp
- Mechanisms for Medicine
- Takeda
- Puretech Ventures
- Novartis
- Cerimon Pharmaceuticals (San Francisco, CA)
BACKGROUND & AIMS: Basiliximab is a chimeric monoclonal antibody that binds CD25 and thereby inhibits interleukin (IL)-2-mediated proliferation of lymphocytes. IL-2 might contribute to the resistance of T cells to corticosteroids. We investigated the efficacy and safety of basiliximab as a corticosteroid-sensitizing agent in patients with corticosteroid-refractory ulcerative colitis (UC). METHODS: We studied 149 patients with moderate to severe UC (Mayo score >= 6 and endoscopic subscore >= 2) despite treatment for at least 14 days with oral prednisone (40-50 mg/day). Subjects were randomly assigned to groups that were given 20 mg (n = 46) or 40 mg (n = 52) basiliximab or placebo (n = 51) at weeks 0, 2, and 4. All subjects received 30 mg/day prednisone through week 2; the dose was reduced by 5 mg each week to 20 mg/day, which was maintained until week 8. At week 8, we compared the rates of clinical remission (Mayo score <= 2, no subscore >1) for patients given basiliximab with the rate for patients given placebo. RESULTS: Twenty-eight percent of patients given placebo, 29% of those given the 40-mg dose of basiliximab, and 26% of those given the 20-mg dose of basiliximab achieved clinical remission (P = 1.00 vs placebo for each dose). Basiliximab was generally well tolerated. Six subjects who received basiliximab had serious adverse events (6.1%) compared with 2 who received placebo (3.9%; P = .72). In subjects given basiliximab, incomplete saturation of CD25 (<50%) on peripheral T cells was associated with the presence of anti-basiliximab antibodies (odds ratio, 21; 95% confidence interval, 2.4 - 184). CONCLUSIONS: Basiliximab does not increase the effect of corticosteroids in the induction of remission in outpatients with corticosteroid-resistant moderate to severe UC.
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