在炎症性肠病中定义部分反应:德尔菲共识和经济评估
Iago Rodríguez-Lago1,2,3, Luis Menchén4,5, José Germán Sánchez-Hernández6
1Hospital de Galdakao-Usansolo, Galdakao, Spain.
在炎症性肠病 (IBD) 中确定部分反应者对于患者的护理至关重要. 这项研究确定了性结肠炎和克罗恩病的部分反应的共识定义,有助于临床决策.
科学领域:
- 胃肠病学和肝病学
- 临床医学
- 炎症性肠病研究
背景情况:
- 在炎症性肠病 (IBD) 的治疗目标正在随着新的治疗和诊断而发展.
- 尽管取得了进展,但在IBD治疗方面仍然存在重大未满足的临床需求.
- 清晰的治疗反应定义对于优化患者护理至关重要.
研究的目的:
- 在IBD的临床实践中建立"部分响应者"的共识定义.
- 在预期的时间内不达到定义的治疗目标的患者.
- 在各种IBD情景中提供评估治疗有效性的明确标准.
主要方法:
- 一次两轮的德尔菲咨询,涉及西班牙60名IBD专业胃肠病专家.
- 一份22项调查问卷涉及四种临床情景:中度性结肠炎 (UC),急性严重UC,光线性克罗恩病 (CD) 和围性CD.
- 达成共识被定义为70%的小组成员使用7点利克特级别的同意;对部分响应者与缓解的相关年度成本的分析.
主要成果:
- 在UC和CD部分响应的定义上达成共识,包括临床得分,生物标志物和成像/内镜发现.
- 部分响应患者的估计年度费用明显高于缓解期患者:2570. 40欧元 (UC) 与820. 20欧元,1607. 30欧元 (光线CD) 与718. 0欧元,2886. 70欧元 (周围CD) 与888. 80欧元.
- 实现长期缓解可以在非药物资源使用和相关成本方面节省大量资金 (55% - 70%).
结论:
- 在四个关键IBD临床场景中制定了部分响应者的正式定义.
- 这些定义可以帮助医疗保健专业人员在临床决策和患者管理中发挥作用.
- 通过更好地识别和管理IBD治疗反应,可以改善患者护理和潜在的成本节约.
更多相关视频
09:11Systematic Scoring Analysis for Intestinal Inflammation in a Murine Dextran Sodium Sulfate-Induced Colitis Model
Published on: February 14, 2021
07:38Multimodal Quantitative Phase Imaging with Digital Holographic Microscopy Accurately Assesses Intestinal Inflammation and Epithelial Wound Healing
Published on: September 13, 2016
相关概念视频
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
