非瘤坏死因子 (TNF) 与TNF对手的比较持久性,用于克罗恩氏病 (CD) 的术后预防
Phillip Gu1, Shishir Dube2, YooJin Lee2
1F. Widjaja Inflammatory Bowel Disease Institute, 8730 Alden Drive, Thalians Bldg, #E222, Los Angeles, CA, 90048, USA. phillip.gu@cshs.org.
非TNF生物药物显示出更好的药物持久性比TNF抗剂对于克罗恩氏病的术后预防,与早期内镜复发的类似率. 这表明非TNF药物可以改善治疗策略.
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 是一个学科.
背景情况:
- 对于术后克罗恩病 (CD) 预防的生物制剂的比较安全性和有效性尚不清楚.
- 药物持续性是耐受性和有效性的现实世界的指标.
- 评估非TNF与TNF抗剂对于术后CD预防至关重要.
研究的目的:
- 为了比较非TNF和TNF抗剂在术后CD预防中的持久性.
- 评估这些生物制剂在预防早期内镜术后复发 (POR) 的比较有效性.
主要方法:
- 对291名从未接受过手术的CD患者进行肠切除的回顾性研究 (2000-2021年).
- 分析了用于术后预防的生物药物.
- 调整为共变量的Cox比例危险和后勤回归模型比较了预防失败和早期内镜POR (15个月内鲁特盖特得分≥i2).
主要成果:
- 与TNF抗剂相比,非TNF抗剂的预防与预防失败的风险显著降低 (aHR 0.26; 95% CI [0.13-0.53]).
- 早期内镜性POR的风险在非TNF和TNF抗组之间是相似的 (aOR 0.66;95% CI [0.32-1.36]).
- 非TNF药物的分层 (抗整合素,抗IL12/23) 显示出一致的结果.
结论:
- 非TNF抗剂在术后CD预防中表现出比TNF抗剂更大的持久性.
- 非TNF和TNF抗剂都显示出早期内镜POR的类似风险.
- 这些发现可能会指导克罗恩病的未来手术后管理策略,等待前性研究的确认.
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