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与炎症性肠病治疗相关的严重感染的比较风险
Nabeel Khan1,2, Ramaswamy Sundararajan1, Dhruvan Patel3
1Department of Gastroenterology, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States.
Inflammatory bowel diseases
|October 16, 2025
概括
在炎症性肠病 (IBD) 患者中,像vedolizumab这样的较新的生物药物与抗瘤坏死因子 (TNF) 抑制剂加上提奥普林 (TPs) 相比,显示了更高的胃肠道感染风险. 在药物类别中,总体感染住院率很低.
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:
- 对于使用较新的生物疗法的炎症性肠病 (IBD) 患者感染住院风险的数据有限.
- 评估不同IBD药物类别的比较感染风险对于患者安全至关重要.
研究的目的:
- 评估IBD患者因感染而入院的整体和比较风险,这些患者接受了各种类型的药物治疗.
- 为了比较较新的生物药物和传统组合疗法之间的感染风险.
主要方法:
- 退伍军人卫生管理局成年IBD患者的回顾性队列研究.
- 对不同IBD药物类别的新发起者的分析,重点是需要住院治疗的感染.
- 时间更新的生存分析,调整了关键混因素.
主要成果:
- 该研究包括14,554名IBD患者,在49.5个月的中位随访期间,有3,131例感染住院治疗.
- 没有任何药物类别显示出与抗瘤坏死因子 (TNF) 抑制剂 + 氨酸 (TPs) 相比,感染住院风险的统计学上显著差异.
- 与抗TNF + TPs相比,vedolizumab与胃肠道感染风险显著增加有关 (HR 1.42);与抗TNF单一治疗相比,vedolizumab的风险较低.
结论:
- 在这个全国性IBD队列中,与抗TNF+TP联合治疗相比,vedolizumab,ustekinumab和tofacitinib没有增加感染住院风险.
- 在研究的药物类别中,与感染有关的住院治疗的总体率很低.
- 结果支持临床决策,强调有效性,并与患者和医生讨论治疗剂的选择.
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