量化患者对风险耐受性的偏好,使用新的双重生物疗法来治疗炎症性肠病
Jui-Chen Yang1, Ellen M Janssen2, Matthew J Wallace1
1Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
患有炎症性肠病 (IBD) 的患者在双重生物疗法 (DBT) 和单一疗法之间没有偏好,但更愿意避免使用皮质类固醇. 他们接受感染风险增加,以获得更高的缓解机会.
科学领域:
- 胃肠病学 胃肠病学
- 药物经济学 药物经济学
- 患者报告的结果.
背景情况:
- 许多炎症性肠病 (IBD) 患者面临现有疗法治疗失败.
- 双重生物疗法 (DBT) 正在成为改善耐火性IBD治疗结果的策略.
- 了解患者对DBT的偏好对于优化治疗策略至关重要.
研究的目的:
- 评估患者对IBD双重生物治疗 (DBT) 和单一治疗的偏好.
- 评估患者对与先进IBD疗法相关的风险的耐受性.
- 为了确定患者愿意接受增加的风险以提高疗效.
主要方法:
- 基于现有的偏好研究,设计了一个离散选择实验 (DCE).
- 招募了患有克罗恩病或性结肠炎的个体,这些人未能接受先进疗法.
- 使用随机参数逻辑模型分析DCE响应以量化偏好.
主要成果:
- 280名IBD患者完成了DCE调查.
- 在DBT和单疗之间没有发现显著的偏好 (P=0.25).
- 患者强烈倾向于避免使用皮质类固醇 (P<0.001),并愿意接受17.5%的严重感染风险,以获得20%的缓解率增加.
结论:
- 患者优先考虑安全有效的IBD治疗方法.
- 对于那些没有对先进疗法的反应的IBD患者来说,DBT是一种潜在的可接受的选择.
- 有效的DCE研究对于确定患者偏好和改善IBD护理是有价值的.
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