维护阶段抗瘤坏死因子水平较低与克罗恩病儿童的治疗失败有关
Jonathan Moses1, Jeremy Adler2,3, Shehzad A Saeed4
1Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford Medicine Children's Health, Palo Alto, CA, USA.
在抗瘤亡因子 (TNF) 治疗中添加低剂量甲状腺素 (LD-MTX) 并没有增加儿科克罗恩病的药物水平. 然而,较高的药物水平与治疗失败的减少有关,趋势有利于阿达利姆巴的联合治疗.
科学领域:
- 胃肠病学 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:
- 儿科克朗氏病通常涉及抗瘤缩因子 (TNF) 治疗.
- 治疗可能会失败,并且正在研究与低剂量口服甲状腺素 (LD-MTX) 的联合治疗.
- 优化抗TNF药物水平可能会改善治疗结果.
研究的目的:
- 为了确定LD-MTX联合治疗是否会增加抗TNF药物水平.
- 评估抗TNF药物水平与治疗失败之间的关联.
- 探索组合治疗对维持治疗药物水平的患者缓解的影响.
主要方法:
- 我们对Combine试验进行了后期分析.
- 包括接受抗TNF单一治疗或与LD-MTX联合治疗的参与者.
- 在随机化后大约4个月测量血清药物度.
主要成果:
- 与单一治疗相比,组合疗法没有显著增加infliximab或adalimumab水平.
- 较低的药物度与因弗利西马布和阿达利穆马布的治疗失败有显著的关联.
- 对于infliximab,没有观察到治疗失败的显著差异,但在Adalimumab组合疗法中观察到减少失败的趋势.
结论:
- 在儿科克罗恩病中,LD-MTX联合治疗没有提高抗TNF药物水平.
- 较高的抗TNF药物水平与治疗失败的风险降低有关.
- 虽然在统计学上并不显著,但趋势表明LD-MTX联合治疗对阿达利姆巴治疗的潜在益处,这需要进一步研究.
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