在初始呈现时急性严重结肠炎后的结果:多中心,前性,儿科队列研究
Jasbir Dhaliwal1,2,3,4, Dominique Tertigas5, Nicholas Carman1
1SickKids IBD Centre, Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
Journal of Crohn's & colitis
|August 21, 2023
概括
大多数患有急性严重性结肠炎 (ASUC) 的儿童需要先进的生物疗法. 肠道微生物组的变化和临床因素预测需要使用因弗力西马布,指导治疗选择.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 炎症性肠道疾病研究研究
- 微生物组科学 微生物组科学
背景情况:
- 儿童急性严重性结肠炎 (ASUC) 在管理和长期结果方面存在独特的挑战.
- 了解最初的呈现和治疗反应对于优化儿科IBD护理至关重要.
研究的目的:
- 评估ASUC儿童在第一次呈现时的结果.
- 确定治疗升级和长期疾病进程的预测因素.
主要方法:
- 新发 ASUC (儿童性结肠炎活动指数 [PUCAI] ≥65) 的儿童 (<17岁) 的未来随访.
- 使用16S rRNA amplicon测序对基线便微生物组合的分析.
- 主要终点:在1年内没有使用皮质类固醇的临床缓解.
主要成果:
- 在105名患有ASUC的儿童中,51%的儿童不耐使用类固醇,并开始服用因弗力西马布;61%的儿童在1年内实现了无皮质类固醇缓解.
- 在ASUC中的肠道微生物群显示较低的α-多样性,减少有益的无氧生物,与轻度UC相比增加了有氧生物.
- 低albuminemia,更高的PUCAI,年龄较大和男性性别预测了对infliximab的需求.
结论:
- 大多数儿科ASUC患者将治疗升级为生物药物,通常是infliximab.
- 识别先进治疗的预测因素可以帮助选择适合ASUC儿童的维持策略.
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