使用免疫抑制剂治疗是否能改善系统性硬化症患者的胃肠道症状?

IF 5.1 2区 医学 Q1 RHEUMATOLOGY
Lea Stamm, Alexandru Garaiman, Mike Oliver Becker, Cosimo Bruni, Rucsandra Dobrota, Muriel Elhai, Sherif Ismail, Suzana Jordan, Norina Zampatti, Aurora Maria Tatu, Oliver Distler, Carina Mihai
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引用次数: 0

摘要

目的:虽然系统性硬化症(SSc)的治疗取得了重要进展,但对于与 SSc 相关的胃肠道(GI)表现,目前仍没有循证的疾病改变疗法。我们旨在通过加州大学洛杉矶分校/硬皮病临床试验联盟胃肠道工具 2.0(GIT)的测量,确定免疫抑制治疗与胃肠道症状严重程度之间的关联:我们挑选了 SSc 患者,他们在 12±3 个月的间隔内至少进行了两次完成 GIT 的检查(进一步称为 "基线 "和 "随访")。研究结果是随访时的 GIT 评分。我们使用了多变量线性回归法,其中包含以下协变量:观察期间的免疫抑制治疗、基线前的免疫抑制治疗、基线 GIT 以及根据临床判断选出的可能影响消化道症状的几个基线参数:我们纳入了 209 名 SSc 患者(82.3% 为女性,中位年龄为 59.0 岁,中位病程为 6.0 年,40 人(19.1%)为弥漫性皮肤 SSc,中位基线 GIT 为 0.19)。其中 71 例患者在观察期间接受过免疫抑制治疗,与未接受过免疫抑制治疗的患者相比,他们的 SSc 总体病情更严重,接受质子泵抑制剂治疗的比例更高。在多变量线性回归中,观察期间的免疫抑制治疗和较低的基线GIT评分与随访时较低的(较好的)GIT评分显著相关:在我们的队列中,免疫抑制剂治疗与较低的 GIT 评分相关,这表明免疫抑制剂对 SSc 患者的消化道表现有潜在影响,需要在前瞻性随机临床试验中加以证实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Does therapy with immunosuppressive drugs improve gastrointestinal symptoms in patients with systemic sclerosis?

Objectives: While important progress was made regarding the treatment of systemic sclerosis (SSc), there is still no evidence-based disease-modifying treatment available for SSc-related gastrointestinal (GI) manifestations. We aimed to identify an association between immunosuppressive therapy and the the severity of GI symptoms, measured by the University of California at Los Angeles/Scleroderma Clinical Trial Consortium Gastro-Intestinal Tract instrument 2.0 (GIT).

Methods: We selected patients with SSc who had at least two visits (further referred to as 'baseline' and 'follow-up') with completed GITs, within an interval of 12±3 months. The study outcome was the GIT score at follow-up. We used multivariable linear regression with the following covariates: immunosuppressive therapy during observation, immunosuppressive therapy before baseline, baseline GIT and several baseline parameters selected by clinical judgement as potentially influencing GI symptoms.

Results: We included 209 SSc patients (82.3% female, median age 59.0 years, median disease duration 6.0 years, 40 (19.1%) diffuse cutaneous SSc, median baseline GIT 0.19). Of these, 71 were exposed to immunosuppressive therapy during the observation period, and, compared with unexposed patients, had overall more severe SSc and a higher prevalence of treatment with proton pump inhibitors. In multivariable linear regression, immunosuppressive therapy during the period of observation and lower baseline GIT scores were significantly associated with lower (better) GIT scores at follow-up.

Conclusion: Immunosuppressive treatment was associated with lower GIT scores in our cohort, which suggests the potential effects of immunosuppressants on GI manifestations in patients with SSc, requiring confirmation in prospective randomised clinical trials.

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来源期刊
RMD Open
RMD Open RHEUMATOLOGY-
CiteScore
7.30
自引率
6.50%
发文量
205
审稿时长
14 weeks
期刊介绍: RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
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