炎症性肠病患者全身类固醇使用和手术率的变化:日本真实世界的数据库分析
Daisuke Hirayama1, Shinichiro Hyodo2, Kazuo Morita2
1Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S1 W17, Chuo-Ku, Sapporo-Shi, Hokkaido, 060-8556, Japan.
Journal of gastroenterology
|March 16, 2024
概括
在炎症性肠病 (IBD) 治疗中,生物药物降低了皮质类固醇的使用率和潜在的手术率. 这项研究表明,在生物药物可用之后,在接受治疗的患者中,使用皮质类固醇更合适,手术更少.
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:
- 建议使用皮质类固醇来诱导炎症性肠病 (IBD) 的缓解,包括性结肠炎 (UC) 和克罗恩病 (CD).
- 该研究评估了30年来IBD药理治疗的变化,重点是系统性皮质类固醇.
- 它评估了2000年代引入的生物疗法对IBD管理的影响.
研究的目的:
- 评估大约30年来IBD药理治疗使用的变化.
- 评估生物疗法对系统性皮质类固醇在IBD的使用的影响.
- 分析生物药物对皮质类固醇剂量,持续时间和UC和CD患者的手术率的影响.
主要方法:
- 在日本使用氏队列数据库 (1990-2021) 进行了回顾性研究.
- 包括接受UC或CD治疗的患者 (≥10岁).
- 结果指标:IBD治疗模式,累积和初始皮质类固醇剂量,治疗持续时间和手术发生率.
主要成果:
- 在UC中,最初的皮质类固醇使用保持稳定;在CD中,它在2006年后显著下降 (后生物可用性).
- 在生物药物变得可用后疾病发病的患者在UC和CD两种情况下的累计皮质类固醇剂量较低.
- 在CD患者的手术率较低,在生物药物可用后疾病发作.
结论:
- 生物可用性导致IBD的皮质类固醇使用减少并变得更合适.
- 生物药物可能会降低手术率,特别是在克罗恩病患者中.
- 这些发现表明,应该转向更有针对性,更有效的IBD治疗策略.
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