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克罗恩氏病的恶化由upadacitinib的幽灵药丸加剧
Chihiro Yunomura1, Shunsuke Kojimahara1, Keiichi Tominaga2
1Department of Gastroenterology, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
一名患有严重克罗恩病 (CD) 的患者因一种独特的外科并发症而经历了治疗失败,称为"幽灵药片现象". 这凸显了在为CD开处方延长释放药物时考虑患者解剖学的关键需要.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 克罗恩氏病 (CD) 是一种慢性炎症性肠病,需要长期管理.
- 耐火性CD通常需要用多种生物药物治疗和手术干预.
- 以前的治疗方法包括infliximab,adalimumab,ustekinumab和vedolizumab,但未能在这个患者中实现缓解.
研究的目的:
- 报告患有克罗恩病的患者用上达西提尼布 (UPA) 治疗失败的情况.
- 为了说明"鬼药现象"对术后CD患者口服药物的疗效的影响.
- 强调在延长释放配方的治疗决策中考虑患者特异性胃肠道解剖学的重要性.
主要方法:
- 一个40多岁的女性患者的病例报告,她有30年的CD病史.
- 综述治疗史,包括多种生物药物和外科手术 (小肠部分切除,结肠术).
- 对上达西提尼布治疗反应的分析,确定失败的原因是由于短肠综合征引起的"鬼药现象".
主要成果:
- 患者的克罗恩病仍然难以控制,尽管有众多的治疗方法.
- 延长释放剂Upadacitinib由于药丸通过结肠道迅速排出而无效,这种现象被称为"幽灵药丸现象".
- 这种并发症阻止了口服药物的治疗效果,患者有显著的术后解剖变化.
结论:
- "幽灵药物现象"可以显著阻碍长期释放口服药物的疗效,在克罗恩氏病患者具有特定的外科病史.
- 当处方延长释放药物如upadacitinib时,仔细考虑患者的胃肠道解剖学和手术状况至关重要.
- 医疗保健专业人员之间的有效沟通对于确保适当的患者管理和预防治疗失败至关重要.
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