Gastroenterology:实现治疗响应的溃疡性结肠炎患者可停止甲氨蝶呤持续治疗

2018-07-09 zhangfan MedSci原创

研究认为,对于已经实现无类固醇治疗响应的溃疡性结肠炎患者,持续的甲氨蝶呤治疗意义不显著

甲氨喋呤可促进溃疡性结肠炎(UC)患者的临床缓解,而非改善内镜下黏膜炎症。近日研究人员开展随机、安慰剂对照试验,考察UC患者接受甲氨蝶呤和类固醇诱导治疗后,单独使用甲氨蝶呤对维持无类固醇治疗响应或临床缓解的效果。

179名UC患者参与研究,患者处于UC活动期,Mayo评分6-12,内镜得分大于2。所有患者先公开接受甲氨蝶呤加类固醇诱导治疗至16周,实现无类固醇响应患者随机接受甲氨蝶呤维持治疗(25 mg/周, n=44)或安慰剂(n=40)直至48周。研究的主要终点是48周无类固醇治疗条件下持续症状缓解。

91名患者(51%)在16周后实现治疗响应,其中81人接受维持治疗。在维持治疗期间,60%的安慰剂组(24人)以及66%的甲氨蝶呤组患者(29人)实现症状缓解。48周,30%的安慰剂组(12/40)以及27%的甲氨蝶呤组患者实现无类固醇治疗条件下持续症状缓解(P=0.86)。

研究认为,对于已经实现无类固醇治疗响应的溃疡性结肠炎患者,持续的甲氨蝶呤治疗意义不显著。

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    2018-09-23 nymo
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    2019-06-17 许安
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    2018-07-21 wxl882001

    学习一下

    0

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    2018-07-09 zb1235672

    学习了!!!!!

    0

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