Am J Gastroenterol:炎症性肠病治疗方案的辅助决策

2017-12-07 zhangfan MedSci原创

生物疗法的用药决策是高度个体化的,人口统计学和疾病特征对治疗决策的影响十分有限,每一个炎症性肠病患者的特征均十分显著,难以进行统计分类

随着炎症性肠病获批药物的不断增加,溃疡性结肠炎以及克罗恩病患者起始治疗方案的选择和转化变得较为困难。近日研究人员对患者生物制剂用药决策的选择方法进行了研究,对每个患者的疾病特征进行分析以辅助临床治疗方案的选择。

研究对IBD患者进行了一种基于适应性选择的联合调查,量化了治疗基本属性,例如疗效、副作用、给药途径以及作用机理。通过软件计算患者偏好,进行回归分析以确定人口统计学和疾病特征对患者治疗偏好的影响。

640名患者参与研究,其中溃疡性结肠炎患者304人,克罗恩病患者336人。回归分析发现,人口统计学和疾病特征对患者治疗偏好无作用,疾病类型除外。与溃疡性结肠炎患者相比,克罗恩病患者更关注治疗的副作用(OR 1.63, 95% CI 1.16-2.30)而溃疡性结肠炎患者更关注治疗的有效性(OR 1.41, 95% CI 1.01-2.00)。

生物疗法的用药决策是高度个体化的,人口统计学和疾病特征对治疗决策的影响十分有限,每一个炎症性肠病患者的特征均十分显著,难以进行统计分类。

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    2017-12-15 许安
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  5. [GetPortalCommentsPageByObjectIdResponse(id=2064261, encodeId=44c2206426170, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Oct 01 01:49:00 CST 2018, time=2018-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905031, encodeId=773c19050314d, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Fri Oct 19 15:49:00 CST 2018, time=2018-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071992, encodeId=be4120e199235, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Dec 15 12:49:00 CST 2017, time=2017-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711288, encodeId=76c91e1128873, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Sep 25 10:49:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268567, encodeId=8e3f26856e32, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Mon Dec 11 11:03:00 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541805, encodeId=9cbb154180581, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Sat Dec 09 08:49:00 CST 2017, time=2017-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547103, encodeId=3981154e103cf, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Sat Dec 09 08:49:00 CST 2017, time=2017-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267591, encodeId=1ad226e5919d, content=学习学习.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Thu Dec 07 18:18:45 CST 2017, time=2017-12-07, status=1, ipAttribution=)]
    2017-12-11 大爰

    学习了谢谢分享!!

    0

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    2017-12-07 1dd8c52fm63(暂无匿称)

    学习学习.继续关注

    0

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Ann Rheum Dis:银屑病关节炎患葡萄膜炎和炎症性肠病的风险

与普通人群和银屑病相比,偶发性PsA患者队列存在发生葡萄膜炎和/或克罗恩病的重大风险。

Am J Gastroenterol:抑郁增加炎症性肠病患者复发风险

研究认为,炎症性肠病患者抑郁症状会导致患者治疗后疾病复发风险增加

Nat Commun:寄生虫中发现的蛋白质带来炎症性肠病新疗法

蠕虫寄生虫中的一种蛋白质有望带来炎症性肠道疾病的全新治疗方案,这种蛋白质可以避免目前免疫抑制剂药物带来的严重副作用。研究结果发表在《自然通讯》杂志上,这项研究表明,一种独特全新蠕虫蛋白,模仿人体中发现的一种细胞因子,称为转化生长因子β。

Frontiers in Immunology:吸烟可能导致炎症性肠病

一项新的研究首次表明了香烟烟雾对肠道炎症的直接影响。韩国的研究人员报告说,将老鼠暴露在香烟烟雾中会导致结肠炎,这是一种类似于克罗恩病的结肠炎症,并确定了一种特定的白细胞和炎症蛋白。这项研究今天发表在开放获取期刊《Frontiers in Immunology》杂志上,可以帮助科学家开发新的治疗炎症性肠病的方法,如克罗恩病,并提高吸烟者对结肠炎风险的认识。之前的研究表明,吸烟会显着增加克罗恩病的风险

2017 AOCC/APAGE共识:接受抗肿瘤坏死因子治疗的炎症性肠病患者结核感染的风险评估

2017年10月,亚洲克罗恩病和结肠炎组织(AOCC)联合亚太地区胃肠病学协会(APAGE)共同发布了接受抗肿瘤坏死因子治疗的炎症性肠病患者结核感染的风险评估和管理共识。文章主要建议内容包接受抗肿瘤坏死因子治疗括结核感染的风险,开始抗肿瘤坏死因子治疗前潜伏或活动性结核病筛查,准备抗肿瘤坏死因子治疗晚期结核感染的管理,抗肿瘤坏死因子治疗期间监测,抗肿瘤坏死因子治疗后结核感染的管理。

2017 AOCC/APAGE共识:接受抗肿瘤坏死因子治疗的炎症性肠病患者结核感染的风险管理

2017年10月,亚洲克罗恩病和结肠炎组织(AOCC)联合亚太地区胃肠病学协会(APAGE)共同发布了接受抗肿瘤坏死因子治疗的炎症性肠病患者结核感染的风险评估和管理共识。文章主要建议内容包接受抗肿瘤坏死因子治疗括结核感染的风险,开始抗肿瘤坏死因子治疗前潜伏或活动性结核病筛查,准备抗肿瘤坏死因子治疗晚期结核感染的管理,抗肿瘤坏死因子治疗期间监测,抗肿瘤坏死因子治疗后结核感染的管理。