在患有克罗恩氏病的儿科患者中生物中止的表征
Sabina Ali1, Brad Pasternak2, Jonathan Moses3
1Division of Pediatric Gastroenterology, Hepatology, and Nutrition, UCSF Benioff Children's Hospital, Oakland, California.
概括
儿科克朗氏肺炎的情况
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 生物疗法对于儿科克罗恩病 (CD) 非常重要.
- 停止多种生物药物治疗可能会限制CD儿童的治疗选择.
- 了解生物断药模式对于优化儿科CD管理至关重要.
研究的目的:
- 描述CD的儿科患者生物使用,停药和评估的模式.
- 为了确定与儿科CD的生物中止相关的因素.
- 为在患有CD的儿童中保持生物疗效的策略提供信息.
主要方法:
- 来自7个美国中心的823名儿科CD患者 (2010-2020年) 的回顾性分析.
- 来自ImproveCareNow注册表和医疗记录抽象的数据.
- 评估生物类型,同时使用免疫调节剂和治疗药物监测 (TDM) 时间 (诱导,主动,反应).
主要成果:
- 86%的患者开始使用生物药物,主要是infliximab和adalimumab.
- 29%的患者因失效,抗体,不良事件或不坚持而停止了第一种生物药物.
- 积极的TDM和同时使用的免疫调节剂与显著降低的生物断药率有关.
结论:
- 儿童CD患者中很大一部分停止使用生物药物,许多人没有接受足够的停止前评估或高剂量治疗试验.
- 同时使用免疫调节剂和主动的TDM是防止生物中止的保护因素.
- 优化生物使用和最大限度地减少停止治疗的策略是必要的,以保持患有CD的儿童的治疗选择.
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