生物疗法对治疗中度至重度性结肠炎的影响:系统性审查和元分析
Ooha Thadiboina1, Syed Saim Ali Shah2, Rubela Ray3
1Internal Medicine, Osmania Medical College, Hyderabad, IND.
Cureus
|July 14, 2025
概括
生物疗法有效治疗中度至严重的性结肠炎 (UC). 本综述证实,与安慰剂相比,在UC患者中,生物药物显著改善了临床反应,缓解和粘膜愈合.
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:
- 性结肠炎 (UC) 是一种慢性炎症性肠病.
- 中度至重度UC需要有效的治疗策略.
- 生物疗法提供了一个有前途的治疗途径.
研究的目的:
- 系统地审查和对生物制剂的疗效进行元分析.
- 评估诱导临床反应,缓解和粘膜愈合在中度至重度UC.
- 在UC患者中评估生物药物与安慰剂的对比.
主要方法:
- 在PubMed,EMBASE和Cochrane图书馆的系统文献搜索.
- 包括随机对照试验和前性队列研究.
- 主要结果的随机效应元分析:临床反应,缓解和粘膜愈合.
主要成果:
- 在诱导临床反应 (OR:2.19),缓解 (OR:3.10) 和粘膜愈合 (OR:1.66) 方面,生物药物显著优于安慰剂.
- 对大多数结果观察到高异质性 (I2 > 50%).
- 证据质量从低到中等不等.
结论:
- 生物疗法在诱导中度至重度UC的反应,缓解和粘膜愈合方面表现出显著的有效性.
- 需要进一步进行高质量的比较研究,以进行直接的生物比较和长期结果评估.
相关概念视频
Drugs for Treatment of Ulcerative Colitis in IBD
239
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
239
Inflammatory Bowel Disease IV: Pharmacological Management
198
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
198
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
204
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
204
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
237
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
237
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
272
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
272
Drugs for Treatment of Constipation-Predominant IBS
347
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
347


