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克罗恩病的早期形切除与与抗瘤坏死因子治疗相比,与改善的长期结果有关:基于人口的队列研究
Manasi Agrawal1, Anthony C Ebert2, Gry Poulsen2
1Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark; The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York.
对于克罗恩氏病 (CD) 的原发性阴囊切除 (ICR) 显示出比抗瘤缩因子 (TNF) 治疗更好的长期结果. 这表明ICR可能是一个可行的第一线治疗选择,以治疗心脏病.
科学领域:
- 胃肠病学 胃肠病学
- 外科胃肠道外科手术
- 临床流行病学临床流行病学
背景情况:
- 早期克罗恩病 (CD) 管理通常涉及抗瘤缩因子 (TNF) 药物.
- 形切除 (ICR) 通常用于复杂的CD或治疗失败.
- 这项研究比较了初级ICR与抗TNF治疗的长期结果.
研究的目的:
- 为了比较原发性阴茎切除 (ICR) 与抗瘤亡因子 (TNF) 治疗在治疗阴茎的克罗恩病 (CD) 中的长期疗效.
- 评估CD相关住院,使用皮质类固醇,进一步手术和围CD发展的复合结果.
主要方法:
- 利用全国范围的登记册来识别2003-2018年间诊断的患有乳房内心CD的患者.
- 包括在诊断后一年内接受ICR或抗TNF治疗的患者.
- 员工调整了考克斯回归以分析长期结果和累积风险.
主要成果:
- 在1279名符合条件的患者中,45.4%有ICR,54.6%接受了抗TNF.
- 在ICR组 (110/1000人/年) 中,复合结局发生的频率较低,相比于抗TNF组 (202/1000人/年).
- ICR与复合结局风险降低33%有关,包括减少皮质类固醇使用和CD相关的手术.
结论:
- 石眼切除 (ICR) 可能是适合的第一线治疗石眼克罗恩病 (CD).
- 这些发现挑战了目前将手术保留给耐火或不耐受病例的模式.
- 观察数据需要在临床决策中谨慎解释.
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