治疗克罗恩病的目标:临床医生的实用指南
Ashish R Srinivasan1,2,3
1Department of Gastroenterology, Austin Health, Victoria, Melbourne 3083, Australia.
World journal of gastroenterology
|January 31, 2024
概括
克罗恩病的治疗目标 (T2T) 方法使用早期干预和严格控制来改善结果. 本综述为将T2T纳入常规临床实践提供了实际指导,强调个性化护理和新兴目标.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 炎症性肠道疾病研究研究
- 临床试验分析
背景情况:
- 以STRIDE-II为指导的治疗到目标 (T2T) 方法旨在通过早期干预和严格的疾病控制来优化克罗恩病的长期结果.
- 目前的T2T目标包括临床缓解,患者报告的结果,生物标志物正常化和内镜治疗,尽管内镜治疗并不总是可行的.
- 个性化治疗目标和患者参与是至关重要的,除了探索非侵入性生物标志物和新的目标,如超神疗法.
研究的目的:
- 为临床医生提供实用指导,以便将治疗到标 (T2T) 方法纳入常规克罗恩病管理中.
- 审查有关T2T策略,流程和护理模式的当前和新兴文献.
- 解决对现实世界数据的需求,并澄清受益于T2T最多的患者子组.
主要方法:
- 关于克罗恩病治疗到标 (T2T) 方法的当前和新兴文献的综述.
- 对随机临床试验 (CALM,STARDUST) 评估T2T疗效的研究结果的分析.
- 检查将T2T整合到现实世界的临床实践中的策略.
主要成果:
- T2T方法看起来很有前途,但需要澄清对患者亚组和克罗恩病特征最有利的情况.
- 在临床试验之外,T2T的实际有效性数据有限,需要实用性研究.
- 缺乏实际指导,阻碍了T2T在常规临床实践中的应用.
结论:
- 将T2T整合到克罗恩病管理中需要个性化护理,患者参与,并考虑新兴的目标.
- 需要进一步的现实研究来确定T2T在不同患者群体中的有效性.
- 实践指导和明确的策略对于支持T2T在临床实践中成功实施至关重要.
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