双重先进疗法治疗炎症性肠病的有效性和安全性——来自西班牙加利西亚的多中心系列研究

IF 4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
M ª Teresa Diz-Lois Palomares, Carmen Pradera Cibreiro, Carmen Cabezal Iglesias, Manuel Barreiro de Acosta, Jesús Martínez Cadilla, Emilio Estévez Prieto, Rocío Ferreiro-Iglesias, Daniel Carpio López, Ana Echarri Piudo
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引用次数: 0

摘要

背景:近年来,尽管采用了新的先进治疗方法,但仍有大约三分之一的炎症性肠病(IBD)患者未能实现疾病控制。两种先进疗法(AT)的结合可以克服这种治疗天花板;因此,这些疗法已经在现实生活的临床实践中进行了经验检验,但缺乏关于如何以及何时将它们结合起来的证据。方法:设计一项多中心回顾性研究,回顾双重先进治疗(DAT)的病例。我们描述了它的特点、有效性、副作用,并检查是否有任何变量与有效性相关。结果:我们在24例患者中描述了29种DAT方案,中位持续时间为7个月(IQR 0.5-43个月)。总体临床缓解率为41.1%(当DAT用于难治性IBD时为36%,当用于免疫介导的炎症性疾病(IMID)和IBD时为60%)。内镜/放射学应答率为31.6% (n = 19)。在17例(58.6%)患者中,由于深度缓解,其中3例患者停用了DAT。无无效或不良事件停药的中位生存期为20个月。根据联合作用机制或添加新AT与回收AT的策略,没有发现有效性差异。结论:在难治性IBD中经经验使用DAT可能导致大约三分之一的患者临床缓解。当DAT同时用于治疗IBD和IMID时,缓解率更有效。但是,在就DAT的类型或时间策略提出具体建议之前,还需要进一步的数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness and safety of dual advanced therapy in inflammatory bowel disease ‒ A multicenter series from Galicia, Spain.

Background: Approximately one-third of patients with inflammatory bowel disease (IBD) do not achieve disease control despite the incorporation of new advanced therapies in recent years. The combination of two advanced therapies (AT) can overcome this therapeutic ceiling; therefore, these therapies have been empirically tested in real-life clinical practice, but evidence is lacking on how and when to combine them.

Methods: A multicenter retrospective study was designed, reviewing cases treated with dual advanced therapy (DAT). We describe its characteristics, effectiveness, adverse effects, and examine whether any variables are associated with effectiveness.

Results: We described 29 DAT regimens in 24 patients, with a median duration of 7 months (IQR 0.5-43 months). Overall clinical remission was 41.1% (36% when DAT was indicated for refractory IBD, and 60% when it was indicated for an immune-mediated inflammatory diseases (IMID) and IBD). Endoscopic/radiological response was 31.6% of the evaluated patients (n = 19). In 17 cases (58.6%), DAT was discontinued, although in 3 of these due to deep remission. The median survival without discontinuation due to inefficacy or adverse events was 20 months. No differences in effectiveness were detected based on the combined mechanisms of action, or on the strategy of adding new versus recycled AT.

Conclusions: Empirical use of DAT in refractory IBD may lead to clinical remission in approximately one-third of patients. Remission rates appeared more effective when DAT is used to simultaneously treat IBD and an IMID. However, further data are needed before specific recommendations can be made regarding type or timing strategy for DAT.

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来源期刊
CiteScore
2.00
自引率
25.00%
发文量
400
审稿时长
6-12 weeks
期刊介绍: La Revista Española de Enfermedades Digestivas, Órgano Oficial de la Sociedad Española de Patología Digestiva (SEPD), Sociedad Española de Endoscopia Digestiva (SEED) y Asociación Española de Ecografía Digestiva (AEED), publica artículos originales, editoriales, revisiones, casos clínicos, cartas al director, imágenes en patología digestiva, y otros artículos especiales sobre todos los aspectos relativos a las enfermedades digestivas.
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