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针对患有急性严重性结肠炎的青少年患者,加强乌帕达西替尼的剂量
Perseus V Patel1, Martina Rigmaiden1, Alka Goyal1
1Division of Pediatric Gastroenterology, Department of Pediatrics, Stanford Medicine Children's Health, Center for IBD and Celiac Disease, Stanford University School of Medicine, Palo Alto, CA 94304, USA.
强化上达西丁治疗可能有助于患有急性严重性结肠炎 (ASUC) 的青少年避免手术. 这项研究发现,所有患者仍然没有切除肠道,许多患者在不使用类固醇的情况下实现了缓解.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 炎症性肠道疾病研究研究
- 药理干预药理干预
背景情况:
- 青少年性结肠炎 (UC) 耐抗瘤坏死因子 (TNF) 治疗带来了重大挑战,往往需要住院治疗或手术.
- 在这个人群中,急性严重性结肠炎 (ASUC) 需要有效的救援疗法.
- 乌帕达西提尼布在ASUC的成年人中显示出作为一种节省胆管切除的药物的前景.
研究的目的:
- 为了评估强化救援upadacitinib剂量在ASUC的青少年患者的临床结果.
- 评估upadacitinib在这个特定的患者群体中节省胆管切除术的潜力.
- 为了确定乌帕达西提尼布作为抗TNF耐火性ASUC在青少年中的救援疗法的疗效.
主要方法:
- 使用案例系列设计来评估临床结果.
- 接受了抗TNF耐火性ASUC的青少年接受了强化剂量的上达西提尼布 (30毫克每天两次) 的治疗.
- 衡量的主要结局是最近的随访时,仍然没有切除肠道的患者比例.
主要成果:
- 包括5名ASUC的青少年患者 (年龄在14-18岁).
- 所有患者在随访期间 (55-203天) 保持没有切除术的状态.
- 百分之六十 (60%) 的患者在不使用皮质类固醇的情况下实现了临床/生化缓解,三名患者接受了用乌斯特基努马布和乌帕达西提尼布的双重先进治疗.
结论:
- 强化upadacitinib的剂量可能成为ASUC.青少年的潜在的节省胆管切除的选择.
- 这种方法对于抗瘤缩因子 (TNF) 治疗不耐药的患者尤为重要.
- 需要进一步的研究,以在更大的队列中证实这些发现.
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