所有生物制剂和小分子在性结肠炎中的比较维护性能:一个网络元分析
Theodore Rokkas1,2, Javier P Gisbert3,4, Konstantinos Ekmektzoglou1,2
1Gastroenterology Clinic, Henry Dunant Hospital, Athens, Greece.
European journal of gastroenterology & hepatology
|March 13, 2024
概括
这项网络元分析比较了中度至重度性结肠炎 (UC) 的维持治疗方法. 乌帕达西提尼布和埃特拉西莫德显示出最佳的疗效,而托法西提尼布和因弗利西马布则提供了最佳的疗效安全平衡.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 生物药物和小分子为中度至严重的性结肠炎 (UC) 提供了新的选择.
- 这些维持治疗的比较疗效和安全性需要进一步研究.
- 需要系统审查和网络元分析 (NWM) 来巩固证据.
研究的目的:
- 进行系统审查和NWM.
- 评估治疗中度至重度UC维护的治疗方法的比较疗效和安全性.
- 评估已批准和新兴的治疗方案.
主要方法:
- 在2023年4月之前搜索了多个数据库 (PubMed/Medline,EMBASE,Cochrane图书馆).
- 主要终点:维持治疗结束时的临床缓解.
- 贝叶斯式NWM与表面积累排名 (SUCRA) 进行有效性和安全性评估.
主要成果:
- 包括20个RCT与7660名患者在20个治疗.
- 两种研究设计:重新随机化和通过治疗.
- 乌帕达西提尼布30毫克/天 (重新随机化) 和埃拉西莫德2毫克/天 (通过治疗) 在疗效方面排名最高.
- 托法西提尼布10毫克 (重新随机化) 和因弗利克西马布3.5毫克/千克Q8W (通过处理) 显示出最佳的疗效安全性.
结论:
- 乌帕达西提尼布和埃特拉西莫德在重新随机化和通过治疗的设计中对UC维持最有效.
- 托法西提尼布和因弗利克西马布在各自的患者群体中提供了最佳的疗效安全平衡.
- 研究结果为中度至重度UC维护的治疗选择指导.
更多相关视频
相关概念视频
Drugs for Treatment of Ulcerative Colitis in IBD
139
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...
139
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 Immunomodulatory Agents
163
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...
163
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
137
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...
137
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
118
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...
118
Drugs for Treatment of Constipation-Predominant IBS
162
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
162


