囊内镜导向的主动治疗到目标与静止克罗恩病患者的持续标准护理:一个随机对照试验
Shomron Ben-Horin1, Adi Lahat1, Bella Ungar1
1Department of Gastroenterology, Sheba Medical Center, Ramat-Gan, Israel; Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel.
视频囊内镜 (VCE) 引导的治疗到目标策略显著降低了克罗恩氏病.
科学领域:
- 胃肠病学 胃肠病学
- 临床试验 临床试验
- 炎症性肠道疾病研究研究
背景情况:
- 对于克罗恩病 (CD) 的最佳治疗到点 (T2T) 策略需要进一步调查.
- 目前正在探索视频囊内镜 (VCE) 在指导CD的主动T2T优化中的实用性.
研究的目的:
- 评估VCE引导的T2T策略与用于管理小肠克罗恩病的标准护理相比的有效性.
- 根据VCE发现,评估主动治疗调整对临床结果的影响.
主要方法:
- 一项随机对照试验,涉及临床缓解中的小肠CD患者.
- 在基线VCE上具有高炎症评分 (易斯评分≥350) 的患者被随机分配到T2T优化或标准护理.
- 主要结局是24个月后疾病恶化率.
主要成果:
- 与标准护理组 (70%) 相比,VCE引导的T2T组的临床发作率明显较低 (25%), (OR,0.14;P = .006).
- 根据易斯评分<350的评估,粘膜愈合在T2T组中更频繁 (OR,4.5;P = .03).
- VCE是安全的,只有一个临时保留的实例.
结论:
- 与标准护理相比,以VCE为指导的治疗到目标策略为缓解期的克罗恩病患者提供了优越的临床结果.
- 积极的基于VCE的治疗优化是管理CD的一个有价值的方法.
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