一项关于炎症性肠病患者从静脉注射到皮下注射英夫利珠单抗和维妥珠单抗的国际多中心研究:TIME 研究。

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Ferdinando D'Amico, Luca Massimino, Giulia Palmieri, Arianna Dal Buono, Roberto Gabbiadini, Benedicte Caron, Paula Moreira, Isabel Silva, Maia Bosca-Watts, Tommaso Innocenti, Gabriele Dragoni, Cristina Bezzio, Alessandra Zilli, Federica Furfaro, Simone Saibeni, María Chaparro, María José García, George Michalopoulos, Nikos Viazis, Gerassimos J. Mantzaris, Pierre Ellul, Javier P. Gisbert, Fernando Magro, Laurent Peyrin-Biroulet, Alessandro Armuzzi, Federica Ungaro, Silvio Danese, Gionata Fiorino, Mariangela Allocca
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引用次数: 0

摘要

背景和目的:英夫利昔单抗(IFX)和维妥珠单抗(VDZ)的皮下注射制剂已被批准用于治疗炎症性肠病(IBD)。我们的目的是评估 IFX 和 VDZ 从静脉注射制剂转为 SC 制剂治疗 IBD 的有效性:这项多中心回顾性研究收集了改用皮下注射 IFX 或 VDZ 的克罗恩病(CD)或溃疡性结肠炎(UC)成年患者的数据。主要终点是12个月时的临床缓解,根据转换时间进行分层。评估的复合终点包括治疗中断、反向转换、类固醇需求和药物优化。一项多变量分析调查了患者特征与治疗结果之间的关系:13个中心的231名患者(59%为UC,53%为男性,平均年龄为44±15岁,68%为IFX)被纳入研究。三分之一的病例(36%)在第 6 周进行了换药。中位转换时间为 13 个月。大多数转用 SC IFX 和 VDZ 的患者在 3 个月(87% 和 77%)、6 个月(86% 和 83%)和 12 个月(63% 和 60%)时临床症状缓解。在多变量分析中,12 个月时的临床缓解率没有差异;但是,在第 6 周时换药的患者在 3 个月(假发现率 (FDR) = .002)、6 个月(FDR -10)或 12 个月(FDR = .08)时出现任何治疗变化的比率较高。基线时的临床疾病活动性(仅在 UC 中)(FDR = .07)和既往接触过生物制剂(FDR = .001)是 6 个月和 12 个月时出现复合终点的风险因素:结论:SC IFX和VDZ在IBD患者的日常临床实践中是有效的。结论:SC IFX 和 VDZ 在 IBD 患者的日常临床实践中非常有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

An international multicentre study of SwiTching from Intravenous to subcutaneous inflixiMab and vEdolizumab in inflammatory bowel diseases: The TIME study

An international multicentre study of SwiTching from Intravenous to subcutaneous inflixiMab and vEdolizumab in inflammatory bowel diseases: The TIME study

Background and Aims

Subcutaneous (SC) formulations of infliximab (IFX) and vedolizumab (VDZ) are approved for the treatment of inflammatory bowel diseases (IBDs). Our aim was to evaluate the effectiveness of switching from intravenous (IV) to SC formulations of IFX and VDZ in IBDs.

Methods

This multicentre, retrospective study collected data of adult patients with Crohn's disease (CD) or ulcerative colitis (UC) switched to SC IFX or VDZ. The primary endpoint was clinical remission at 12 months stratified based on timing of switch. A composite endpoint consisting of therapy discontinuation, reverse-switch, need for steroids, and drug optimization was evaluated. A multivariate analysis investigated the association between patients' characteristics and outcomes.

Results

Two hundred and thirty-one patients (59% UC, 53% male, mean age 44 ± 15 years, 68% IFX) from 13 centres were included. The switch occurred at Week 6 in a third of cases (36%). Median time to switch was 13 months. Most patients switched to SC IFX and VDZ were in clinical remission at 3 (87% and 77%), 6 (86% and 83%) and 12 (63% and 60%) months. In the multivariate analysis, there was no difference in clinical remission rate at 12 months; however, patients switched at Week 6 had a higher rate of experiencing any therapeutic changes at 3 (false discovery rate (FDR) = .002), 6 (FDR <1 × 10−10) or 12 months (FDR = .08). Clinical disease activity at baseline (only in UC) (FDR = .07) and previous exposure to biologics (FDR = .001) were risk factors for composite endpoint at 6 and 12 months.

Conclusion

SC IFX and VDZ are effective in daily clinical practice in IBD patients. Switching patients in remission reduces the risk of negative outcomes.

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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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