开发和验证一种临床决策支持工具,用于预测用乌斯特基努马布治疗克朗氏病的疾病进展
Lingya Yao1,2, Yushu Cao1,2, Chenhao Bai1,2
1Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
Journal of clinical medicine
|November 27, 2025
概括
一个新的临床决策支持工具 (CDST) 有助于预测克罗恩病.
科学领域:
- 胃肠病学和肝病学
- 药理学和治疗学 药理学和治疗学
- 临床决策支持系统 临床决策支持系统
背景情况:
- 乌斯特基努马布 (UST) 是克罗恩病 (CD) 的一项成熟治疗方法,但预测长期疾病进展仍然具有挑战性.
- 有限的数据存在于影响中国CD患者接受UST的疾病进程的因素.
- 开发预测工具对于个性化治疗策略至关重要.
研究的目的:
- 开发和验证临床决策支持工具 (CDST),用于识别在乌斯特基努马布 (UST) 治疗期间患有克罗恩病 (CD) 的中国患者患病进展风险较低的患者.
- 确定这一患者队列中疾病进展的关键基线预测因素.
主要方法:
- 这是一项多中心的,追溯的观察性研究,对533名中国CD患者进行了UST治疗.
- 收集基线特征,包括先前的生物使用,疾病严重程度,C-反应蛋白和血红蛋白.
- 使用后勤回归和AUC分析开发和验证一个针对UST的CDST (UST-CDST).
主要成果:
- 有四个因素与疾病进展有关:先前的生物学因素,基线疾病严重程度,C-反应蛋白和血红蛋白.
- 在UST-CDST的AUC达到0.88 (内部验证) 和0.66 (外部验证).
- 该工具成功地将患者分为低风险和高风险组,在52周内进展.
结论:
- 经过验证的UST-CDST可以在一年内确定中国的CD患者可能在UST治疗中取得进展或不取得进展.
- 该工具有助于临床决策,并支持克罗恩病的个性化治疗方法.
- 评分系统有助于对Ustekinumab治疗的患者进行风险分层.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
469
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...
469
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
465
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...
465
Drugs for Treatment of Ulcerative Colitis in IBD
435
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...
435
Inflammatory Bowel Disease II: Crohn's Disease
932
Introduction
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...
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...
932
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
620
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
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...
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...
620
Inflammatory Bowel Disease IV: Pharmacological Management
452
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...
452


