P014 克罗恩氏病患者的术后复发 接受阿达利穆马布治疗与因弗利克西马布治疗:系统性审查和元分析
Luke Frankl1, Ahmad Tarakji1, Shintaro Akiyama2
1University of Kansas Medical Center, Kansas City, Kansas, United States.
The American journal of gastroenterology
|July 18, 2023
概括
在克罗恩氏病患者手术后维持缓解时,因弗利西马布和阿达利穆马布的疗效相似. 这次元分析发现,这两种抗瘤缩因子剂之间的临床和内镜缓解和不良事件的比较率相似.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 克罗恩氏病 (CD) 经常需要肠切除,术后复发率高.
- 抗瘤坏死因子 (抗TNF) 药物用于减少POR,但直接比较infliximab (IFX) 和adalimumab (ADA) 是有限的.
- 了解IFX和ADA的比较疗效对于优化术后CD管理至关重要.
研究的目的:
- 为了比较Infliximab (IFX) 与Adalimumab (ADA) 的疗效,在术后克罗恩病 (CD) 患者中维持临床和内镜缓解.
- 评估该患者群体中与IFX和ADA相关的安全性概况和不良事件率.
- 提供基于证据的见解,在CD.肠切除后选择抗TNF疗法.
主要方法:
- 对比研究进行了系统的元分析,搜索了主要的生物医学数据库,截至2021年5月.
- 包括的研究评估了术后CD患者的IFX和ADA,重点关注临床和内镜缓解率.
- 计算了聚合的发病率比率和风险比率,以比较治疗结果和不良事件.
主要成果:
- 在IFX和ADA之间维持临床缓解 (IRR0.75;95%CI0.43-1.3) 或内镜缓解 (IRR0.94;95%CI0.71-1.2) 之间没有观察到统计学上显著的差异.
- 两种抗TNF药物之间的不良事件率也相似 (RR=0.56,95% CI 0.068-4.5).
- 在包括的研究中发现了低到中等的异质性,并且没有显著的出版偏差.
结论:
- 在克罗恩氏病中,因弗利西马布和阿达利穆马布在维持术后缓解方面表现出可比的疗效和安全性.
- 这些发现表明,任何一种药物都可以考虑用于治疗术后CD复发.
- 局限性包括少数研究和患者,以及缺乏随机对照试验.
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