生物治疗修改有效性在同时炎症性肠病和结性脊柱炎:在一个单一的三级中心的回顾性队列研究
Einat Savin1,2, Niv Ben-Shabat1,2, Asaf Levartovsky2,3
1Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel.
Journal of clinical medicine
|November 25, 2023
概括
在90天内,对同时诊断患有缩性脊柱炎 (AS) 和炎症性肠病 (IBD) 的患者进行生物疗法的修改,显著改善了这两种疾病的临床结果.
科学领域:
- 风湿病学和胃肠道学
- 免疫学和炎症性疾病
背景情况:
- 结性脊柱炎 (AS) 和炎症性肠病 (IBD) 的同时发生是公认的,影响5-10%的患者.
- 目前对于同时诊断AS和IBD的患者缺乏治疗指南,因此需要进一步研究最佳管理策略.
- 了解治疗变化及其对该患者群体临床结果的影响对于改善护理至关重要.
研究的目的:
- 研究在IBD后被诊断为AS的患者的治疗修改模式,或者反之亦然.
- 评估这些治疗修改对AS和IBD临床结果的影响.
- 确定AS和IBD同时存在的患者临床改善的预测因素.
主要方法:
- 一项回顾性队列研究分析了68名患有IBD和AS同时存在的患者的数据,这些患者在2009-2022年期间被诊断为IBD和AS.
- 数据包括人口统计,药物史,第二次诊断时的治疗变化以及基线和3个月后续的疾病活性.
- 来自以色列Sheba医疗中心的电子健康记录被用于数据提取.
主要成果:
- 85%的患者在第二次诊断后接受了治疗修改.
- 开始或修改生物疗法 (切换/增强) 与90天后AS或IBD的临床改善率显著更高 (68%对32%,p=0.004).
- 生物修饰成为临床改善的独立预测因素 (OR 3.69,p=0.037).
结论:
- 在第二次诊断时进行的生物治疗修改与AS和IBD同时存在的患者的改善临床结果有关.
- 这些发现强调了量身定制的治疗调整在管理这些相互交织的疾病的患者的重要性.
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