在infliximab失败后儿童性结肠炎的预后:基于多中心注册的队列研究
Ryusuke Nambu1, Takahiro Kudo2, Nao Tachibana3
1Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan.
儿童性结肠炎 (UC) 患者停止使用因弗利克西马布 (IFX) 时,结肠切除率很高. 在2018年中期之后,由于新的生物药物和小分子药物变得可用,预后有所改善.
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
- 免疫调节疗法 免疫调节疗法
背景情况:
- 英弗利西马布 (IFX) 是小儿性结肠炎 (UC) 的关键生物药物.
- 有限的数据存在于IFX在儿科UC中断后的结果.
- 了解IFX失效对于治疗优化至关重要.
研究的目的:
- 调查IFX失败后儿科UC患者的临床过程和预后.
- 确定与儿科UC停止IFX治疗相关的风险因素.
- 为了评估胆管切除率和随时间变化的预后变化.
主要方法:
- 使用日本儿科炎性肠病注册表 (2012-2020) 进行的前性队列研究.
- 分析了75名儿科UC患者接受IFX治疗,重点关注36名停止治疗的患者.
- 对IFX失败后的风险因素和胆管切除率的统计分析.
主要成果:
- 开始时UC的严重程度和缺乏免疫调节剂治疗是IFX失败的重要风险因素.
- 在IFX失败后的1年内,累积切除术率达到41.3%,在IFX失败后的2年内达到47.5%.
- 在2018年中期之前停止IFX治疗的结肠切除率更高,这表明使用较新的疗法可以改善结果.
结论:
- 大约50%的儿科UC患者在IFX失败后的两年内进行大肠切除术.
- 自2018年中期以来,新的生物药物和小分子药物的可用性似乎改善了IFX失败后的预后.
- 早期识别IFX衰竭的风险因素对于管理儿科UC至关重要.
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