在接受托法西提尼布治疗的患有急性严重性结肠炎的患者的术后结果,接受大肠切除术
Charlotte Larson1, Jeffrey A Berinstein2, Nicholas Tedesco2
1Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan.
概括
与infliximab相比,在切除肠道之前治疗急性严重性结肠炎 (ASUC) 的托法西提尼布与整体术后并发症的减少有关. 然而,在这项回顾性研究中,两种治疗方法之间的严重并发症风险并没有显著差异.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 外科手术的结果
背景情况:
- 在急性严重性结肠炎 (ASUC) 患者中,高达30%的患者尽管接受了医疗治疗,但仍需要进行结肠切除术.
- 像托法西提尼布这样的简氏激酶 (JAK) 抑制剂是ASUC的新兴治疗方法.
- 对ASUC的托法西提尼布和因弗力西马布后术后并发症进行比较的数据有限.
研究的目的:
- 为了评估ASUC患者中术后并发症的风险,在切除术前接受托法西提尼布的患者与用infliximab治疗的患者相比.
- 评估tofacitinib和infliximab治疗组之间整体和严重的术后并发症的差异.
主要方法:
- 进行了一项多中心,回顾性,病例控制研究.
- 经过小肠切除术的ASUC患者根据先前的托法西提尼布或因弗利克西马布治疗情况进行了比较.
- 用多变量回归分析对开放性手术和皮质类固醇暴露进行了调整,以比较结果,主要是30天内严重的术后并发症.
主要成果:
- 该研究包括41名托法西提尼布治疗患者和68名因弗力西马布治疗患者.
- 托法西提尼布治疗的患者的整体术后并发症率显著降低 (31.7%与64.7%相比).
- 在严重的术后并发症中没有发现显著差异 (12%对27.9%),尽管多变量分析显示托法西提尼布的风险较低的趋势 (OR 0.28;P = .061).
结论:
- 与infliximab相比,在切除术前对ASUC的托法西替尼治疗与整体术后并发症的发生率显著降低.
- 在两个治疗组之间没有观察到严重的术后并发症风险的显著差异.
- 需要进行更大规模的前性试验来验证这些发现.
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