结合颗粒细胞 - 单细胞非雷斯和乌斯特基努马布:多中心和回顾性研究
Iago Rodríguez-Lago1, Claudia Herrera-deGuise2, Maia Boscá-Watts3
1Gastroenterology Department, Hospital Universitario de Galdakao, Biobizkaia Health Research Institute, Galdakao, Spain.
概括
结合乌斯特基努马布 (UST) 的颗粒细胞 - 单细胞非瑞斯 (GMA) 在性结肠炎 (UC) 患者中有效地恢复了反应,这些患者以前未能通过UST. 这种组合疗法在耐火性UC病例中显示出显著的临床改善和类固醇中止.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 性结肠炎 (UC) 是一种慢性炎症性肠病.
- 对乌斯特基努马布 (UST) 的初级不响应 (PNR) 或响应丧失 (LOR) 构成了治疗挑战.
- 颗粒细胞 - 单细胞化 (GMA) 是一种已确立的UC治疗方法,通常与抗TNF药物一起使用.
研究的目的:
- 评估结合GMA与UST的疗效和安全性,在患有PNR或LOR到UST的UC患者中.
- 评估这种联合方法在耐火性UC中的临床结果和安全性.
主要方法:
- 在12个IBD单位进行了回顾性研究.
- 包括耐火性UC或未分类IBD (IBD-U) 接受联合GMA和UST的患者.
- 在GMA后1个月和6个月使用部分梅奥得分,C反应蛋白 (CRP) 和便calprotectin (FC) 评估疗效.
主要成果:
- 包括17名患者 (15UC,2IBD-U);大多数患者先前暴露于抗TNF和/或vedolizumab.
- 在1个月和6个月的部分梅奥得分显著降低 (p=0.042,p=0.007).
- 6个月后便calprotectin显著下降 (p=0.028);64%的类固醇依赖患者停止使用类固醇. 报告了一次不良事件.
结论:
- 结合GMA和UST可以在选定的UC患者中恢复对UST的PNR或LOR反应.
- 这一策略为耐火性UC提供了潜在的治疗选择.
- 这种组合在改善临床和内镜结果方面似乎是安全和有效的.
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