对于性结肠炎的Infliximab有效性的种族差异:证据综合和效果修改评估
Stefanos Bonovas1,2, Andreas G Tsantes3, Rozeta Sokou4
1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy.
Journal of clinical medicine
|January 23, 2024
概括
这项研究发现,在治疗亚洲和高加索人群的性结肠炎 (UC) 时,因弗力西马布 (IFX) 的有效性没有显著的种族差异. 进一步的研究应该包括更多的种族少数群体来证实这些发现.
科学领域:
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
- 健康差异 在健康上的差异
背景情况:
- 性结肠炎 (UC) 治疗疗效因种族不同而有所不同.
- 因弗利西马布 (IFX) 是适度至重度UC的关键生物疗法.
- 了解IFX疗效的种族差异对于公平的患者护理至关重要.
研究的目的:
- 调查因弗利克西马布 (IFX) 对性结肠炎 (UC) 治疗疗效的潜在种族差异.
- 使用综合试验数据,比较亚洲和高加索人群之间的IFX疗效.
主要方法:
- 在UC中对IFX进行五项随机,安慰剂对照试验的综合数据的分析.
- 利用证据综合和统计相互作用测试来比较种族特异性疗效.
- 对临床反应,缓解和粘膜愈合的相对风险 (RRR) 的计算比率.
主要成果:
- 在诱导临床反应 (RRR=0.89) 或缓解 (RRR=0.58) 的IFX疗效方面,没有实质性证据表明种族差异.
- 粘膜愈合诱导 (RRR=0.99) 和维持缓解 (RRR=0.81) 也没有显著的种族差异.
- 保持粘膜愈合 (RRR=0.84) 在亚洲和高加索参与者之间没有显著差异.
结论:
- 在亚洲和高加索地区的性结肠炎 (UC) 患者中,因弗利西马布 (IFX) 似乎具有可比的疗效.
- 目前的证据不支持IFX对UC结果的有效性存在显著的种族差异.
- 建议在未来的试验中扩大种族少数群体的纳入,以充分评估治疗的有效性.
相关概念视频
Drugs for Treatment of Ulcerative Colitis in IBD
142
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
142
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
139
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
139
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
166
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
166
Inflammatory Bowel Disease IV: Pharmacological Management
127
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
127
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
120
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
120
Inflammatory Bowel Disease I: Ulcerative Colitis
187
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
187


