在炎症性肠道疾病中,阿扎西奥普林单一治疗的戒断:一项回顾性单一中心研究
Martina Crepaldi1, Daria Maniero1, Alessandro Massano1
1Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua 35128, Italy.
World journal of gastroenterology
|August 7, 2023
概括
停止阿扎西奥普林 (AZA) 治疗炎症性肠病 (IBD) 缓解是安全的. 通过AZA治疗实现缓解的患者在停止服用药物后,复发风险降低了83%.
科学领域:
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
- 免疫抑制疗法 免疫抑制疗法
背景情况:
- 在炎症性肠病 (IBD) 管理中,对于阿扎西奥普林 (AZA) 的最佳持续时间或停止时间没有确定的共识.
- 在患者护理中,平衡长期的AZA风险与停止后的复发概率至关重要.
研究的目的:
- 调查在炎症性肠病 (IBD) 患者中停止阿扎西奥普林 (AZA) 治疗后的临床结果和复发事件.
主要方法:
- 对1995年至2022年间停止服用AZA的成人IBD患者 (性结肠炎和克罗恩病) 的回顾性分析.
- 收集的数据包括治疗持续时间,停止原因和复发模式.
- 考克斯回归模型用于评估不同患者子组的复发风险.
主要成果:
- 在274名患者中,34%的患者在第一年内停止了AZA,而10%的患者继续治疗超过10年.
- 停药的原因包括原发性失败/复发 (30%),疾病缓解 (25.2%) 和副作用 (例如不耐受,细胞衰退,胰腺疾病).
- 由于缓解而停止AZA治疗的患者的复发风险降低了83%,1年和2年无复发率分别为89%和79%.
结论:
- 阿扎西奥普林 (AZA) 是一种有效且一般安全的IBD治疗方法,需要对副作用进行警监测.
- 实现缓解的患者中很少 (10%) 需要在AZA停止后一年内重新开始治疗.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
195
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
195
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
355
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
355
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
173
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
173
Inflammatory Bowel Disease IV: Pharmacological Management
152
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
152
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
153
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
153
Inflammatory Bowel Disease II: Crohn's Disease
291
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
291


