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第二种JAK抑制剂在性结肠炎中的有效性和安全性:J2J多中心研究
Mathilde Osty1, Romain Altwegg2, Mélanie Serrero3
1Gastroenterology Department, Hôpital Henri Mondor, APHP, Créteil, France.
Alimentary pharmacology & therapeutics
|May 22, 2025
概括
切换到第二种Janus激酶抑制剂 (JAKi) 能为大约一半的性结肠炎患者提供临床缓解. 这一策略被发现是安全和有效的,与filgotinib相比,upadacitinib显示出更高的缓解率.
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:
- 关于在性结肠炎 (UC) 管理中切换Janus激酶抑制剂 (JAKi) 的数据有限.
- 三种JAK抑制剂已在UC中表现出有效性,但类内切换策略没有得到充分记录.
研究的目的:
- 评估在中度至重度UC患者中使用二线JAK抑制剂的有效性和安全性.
- 为了比较不同JAK抑制剂作为二线治疗时的结果.
主要方法:
- 进行了一项多中心,回顾性,观察性队列研究.
- 包括患有中度至重度UC的患者,他们未能或不能耐受第一个JAK抑制剂.
- 主要结局:在8-14周无类固醇临床缓解 (SFCR) (部分梅奥得分≤2,没有个体子得分>1).
主要成果:
- 在169名患者中,有81名患者实现了SFCR. 与菲尔戈提尼布 (18/54) 和托法西提尼布 (5/10) (p=0.03) 相比,乌帕达西提尼布的SFCR率 (58/105) 更高.
- 乌帕达西替尼比菲尔戈提尼布 (OR=3.15) 独立地与SFCR的几率更高有关.
- 在6个月的药物持续时间为upadacitinib的72.8%,filgotinib的57.2%,tofacitinib的66.7%. 不良事件导致5%的患者戒药;没有报告重大安全事件.
结论:
- 第二线JAK抑制剂治疗可以在约一半的UC患者中诱导临床缓解.
- 转换JAK抑制剂通常耐受良好,而upadacitinib在实现缓解方面显示出潜在的优势.
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