根据UST-CDST分类对用乌斯特基努马布治疗的克罗恩病患者临床复发的同时使用免疫调节剂的影响:一个多中心研究
Joo Hye Song1, Gyeol Seong2, Jongbeom Shin3
1Department of internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Digestive diseases and sciences
|February 21, 2026
概括
将免疫调节剂添加到ustekinumab (UST) 治疗中减少了克罗恩氏病 (CD) 复发,特别是在低至中等响应患者中. UST临床决策支持工具 (UST-CDST) 可以帮助选择患者进行组合治疗.
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:
- 乌斯特基努马布 (UST) 用于治疗活跃的克罗恩病 (CD).
- 同时使用免疫调节剂和UST的有效性以及患者选择标准仍在争论中.
- 临床决策支持工具 (UST-CDST) 是为了预测缓解而开发的.
研究的目的:
- 评估UST与同时使用免疫调节剂对CD患者复发的影响.
- 评估UST-CDST的可行性,以选择可能受益于同时接受免疫调节剂治疗的患者.
主要方法:
- 患者中度至重度CD耐受常规疗法和接受UST治疗的患者被纳入.
- 临床复发是由特定的临床事件来定义的.
- 使用卡普兰-梅尔分析来评估有效性和UST-CDST的查能力.
主要成果:
- 同时使用免疫调节剂与明显较低的累积复发率相关 (p=0.024).
- 通过UST-CDST确定为低至中等响应的患者,在组合治疗中显示出更高的无复发存活率 (p=0.046).
- 在高概率响应者中没有观察到这种益处 (p=0.439).
结论:
- 与UST同时使用免疫调节剂可降低CD患者临床复发的风险.
- 组合治疗的益处在低至中等概率的响应者中最为明显.
- UST-CDST显示出作为指导同时使用免疫调节剂的决策工具的潜力.
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