在炎症性肠道疾病中,与停止服用5-氨基酸盐相关的复发风险:系统审查和元分析
Arteen Arzivian1, David T Rubin2, Cynthia H Seow3,4
1Faculty of Medicine, Health and Human Sciences, Macquarie Medical School, Macquarie University, Sydney, NSW, Australia.
Inflammatory bowel diseases
|December 3, 2025
概括
discontinuing mesalamine (5-ASA) 单疗法增加了性结肠炎 (UC) 的复发风险. 然而,停止5-ASA可能对UC或克罗恩病是安全的.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 梅萨拉胺 (5-氨基酸,5-ASA) 是对轻度至中度性结肠炎 (UC) 的主要治疗方法.
- 持续使用5-ASA会带来一些挑战,包括成本,副作用和治疗延迟.
- 在特定的患者群体中,可以考虑停止5-ASA治疗,但其对疾病结局的影响尚不清楚.
研究的目的:
- 评估静止性性结肠炎 (UC) 或克罗恩病 (CD) 患者疾病复发的相对风险 (RR).
- 为了比较停止5-ASA治疗的患者和继续治疗的患者之间的复发风险.
主要方法:
- 在五个数据库中进行了全面的文献搜索,截至2024年7月.
- 有资格的研究经过了质量评估,并被分为六个临床队列.
- 使用元分析技术分析了复发的相对风险 (RR).
主要成果:
- 在UC患者中,停止口服5-ASA单一治疗显示,复发风险增加了60% (RR,1.60).
- 在UC患者中,停用直肠5-ASA与复发风险增加2.03倍有关 (RR,2.03).
- 在接受免疫调节剂和/或生物制剂的患者中,5-ASA停止并没有显著增加复发风险.
结论:
- 在UC患者中,停止口服或直肠5-ASA单疗与更高的复发风险有关.
- 对于接受先进疗法 (免疫调节剂/生物药物) 的UC或CD患者来说,5-ASA停药似乎是安全的.
- 对接受先进疗法的患者来说,监测5-ASA的停药可能是一个可行的策略.
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