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在IBD中达到治疗上限:高级组合治疗 (ACT) 可以提供解决方案吗?
Virginia Solitano1, Jurij Hanžel2, Maria Manuela Estevinho3
1Division of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy; Division of Gastroenterology, Department of Medicine, Western University Schulich School of Medicine, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
先进的组合治疗 (ACT) 显著改善了炎症性肠病 (IBD) 患者的治疗结果. 虽然有效,但标准化ACT协议和确保长期安全仍然是这种非标签疗法的关键挑战.
科学领域:
- 胃肠道学和免疫学
- 药理学和治疗学 药理学和治疗学
背景情况:
- 炎症性肠病 (IBD) 包括诸如克罗恩病和性结肠炎等慢性疾病.
- 目前的IBD治疗方法通常涉及使用生物药物或小分子的单疗法.
- 先进的组合治疗 (ACT) 结合了具有独特作用机制的疗法.
研究的目的:
- 审查关于ACT在IBD治疗中的有效性和安全性的现有证据.
- 评估ACT的临床前数据,现实世界的证据和随机对照试验 (RCT).
主要方法:
- 科学文献的叙述性审查.
- 随机对照试验的系统审查,评估IBD中的ACT.
- 分析临床前研究和现实世界的数据.
主要成果:
- 对RCT的系统审查表明,ACT显著改善IBD患者的临床结果.
- 在审查的RCT中没有发现任何重大安全问题.
- 试验设计和结果测量的变化需要标准化努力.
结论:
- 在IBD管理方面,ACT证明了令人信服的有效性.
- 挑战包括标准化治疗方案和确保长期安全.
- 目前的临床使用是非标签的,需要仔细考虑患者特异性和未来的生物标志物导向试验.
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