针对炎症性肠病的治疗目标的好处和挑战
Jack West1, Katrina Tan2, Jalpa Devi3
1Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Melbourne 3052, Australia.
Journal of clinical medicine
|October 14, 2023
概括
在炎症性肠病 (IBD) 中,治疗到标 (T2T) 方法提供了好处,但也面临着挑战. 解决诸如定义粘膜愈合和改善患者/临床医师遵守等问题对于在IBD护理中有效实施T2T至关重要.
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:
- 患者的症状和实际的炎症性肠病 (IBD) 活动之间存在显著的差异.
- 仅仅基于症状的治疗升级可能不会有效地改变疾病的进程.
- STRIDE-II声明 (2021) 建议在IBD管理中采用治疗到目标 (T2T) 方法.
研究的目的:
- 审查IBD中T2T方法的好处和挑战.
- 讨论改善T2T在临床实践中的实施的潜在解决方案.
主要方法:
- 审查STRIDE-II立场声明和相关文献.
- 对T2T方法实施当前局限性的分析.
- 讨论影响现实世界的可行性和患者/临床医生接受度的因素.
主要成果:
- 广泛的T2T实施受到缺点的阻碍,包括缺乏标准化的定义 (例如,用于粘膜愈合),异质的结果数据和有限的回顾性研究.
- 关于严格监测的可行性,现实世界存在最小的证据,并指出患者遵守率不够优.
- 有限的研究表明,需要提高T2T方法的患者和临床医生的接受度.
结论:
- 在现实世界中,T2T的应用受到重复内镜评估的需要和缺乏关于整合治疗目标的指导的限制.
- 解决这些挑战对于优化T2T战略和改善IBD患者护理至关重要.
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