难以治疗的炎症性肠病:来自国际共识会议的结果
Tommaso Lorenzo Parigi1, Ferdinando D'Amico2, Maria T Abreu3
1Department of Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy; Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
The lancet. Gastroenterology & hepatology
|July 9, 2023
概括
定义难以治疗的炎症性肠病 (IBD) 对研究至关重要. 现在有一个共识定义存在,重点关注治疗失败和特定疾病特征,以更好地识别患者和试验.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 炎症性肠道疾病研究研究
背景情况:
- 许多炎症性肠病 (IBD) 患者经历了持续的症状,尽管最佳的治疗.
- 这些患者被称为难以治疗的IBD,需要新的治疗策略.
- 缺乏标准化的定义阻碍了难以治疗的IBD的研究和数据比较.
研究的目的:
- 为难以治疗的IBD建立一个共同的,操作性的定义.
- 引导临床研究,并确定患者的先进治疗策略.
主要方法:
- 国际炎症肠病研究组织 (IBD) 终点集群召开了一次共识会议.
- 16名国际参与者对20项与难以治疗的IBD标准相关的陈述进行了投票.
- 至少需要75%的共识才能就定义达成一致.
主要成果:
- 难以治疗的IBD是由生物药物/高级小分子 (≥2个作用机制) 的失败所定义的.
- 其他标准包括术后克朗氏病复发 (成人≥2切除,儿童≥1).
- 慢性抗生素耐药性毛囊炎,复杂的近部疾病和损害心理社会并发症也符合条件.
结论:
- 拟议的定义标准化了难以治疗的IBD的报告和临床试验招生.
- 这种共识有助于识别那些可能受益于增强治疗方法的患者.
- 采用这些标准有助于对耐火性IBD病例的研究和临床管理.
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