Lancet Gastroenterol Hepatol:用生物类似物替代英夫利昔治疗炎性肠病的耐受性良好

2018-03-30 MedSci MedSci原创

对慢性炎性疾病进行生物治疗可改善预后,但会增加医疗费用。用生物类似物代替原装英夫利昔(inflimab)可降低费用,但相关的药代动力学和潜在的免疫原性的前瞻性数据不足。有研究人员发现应用生物相似无CT-P13代替原装英夫利昔后的英夫利昔血清浓度并不比英夫利昔持续治疗的炎性肠病患者的差。SECURE研究是一个在比利时和荷兰的13个地点开展的前瞻性的开放标签的国际性非劣效性多中心临床4期试验,招募年满

对慢性炎性疾病进行生物治疗可改善预后,但会增加医疗费用。用生物类似物代替原装英夫利昔(inflimab)可降低费用,但相关的药代动力学和潜在的免疫原性的前瞻性数据不足。有研究人员发现应用生物相似无CT-P13代替原装英夫利昔后的英夫利昔血清浓度并不比英夫利昔持续治疗的炎性肠病患者的差。

SECURE研究是一个在比利时和荷兰的13个地点开展的前瞻性的开放标签的国际性非劣效性多中心临床4期试验,招募年满18岁的临床确诊的溃疡性结肠炎或克罗恩(Crohn)病患者,处于临床缓解期,且采用英夫利昔持续治疗30周以上。患者改为CT-P13治疗,注射时间与英夫利昔相同(5mg/kg 每7-9周),换药后随访16周,分别于起始(第一次用CT-P13前)、8周和16周检测英夫利昔的血清浓度。主要结点:换药16周时英夫利昔的血清浓度,并将溃疡性结肠炎患者和克罗恩病患者分开评估。非劣效性标准为15%。

2015年6月5日-2016年4月6日,共招募了120位炎性肠病患者:溃疡性结肠炎59位,克罗恩病61位。46位溃疡性结肠炎患者和42位克罗恩病患者组成预协议人群。16周时,改为CT-P13治疗患者的血清英夫利昔浓度的几何平均率为110.1%(90% CI 96.0-126.3)。在两种情况下,90% CI的下界明显高于85%的预定的非劣性界限。6位患者出现严重副反应。仅一人,出现肛周脓肿,被鉴定与治疗相关。

由英夫利昔改为CT-P13治疗炎性肠病患者耐受性好。以后还需要进行更多试验评估CT-P13用于活动性疾病的效果和安全性。

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    2018-06-29 howi
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    2018-11-24 许安
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  4. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417678, encodeId=144c141e678da, content=<a href='/topic/show?id=aada80351ae' target=_blank style='color:#2F92EE;'>#耐受性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80351, encryptionId=aada80351ae, topicName=耐受性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43843300457, createdName=Smile2681, createdTime=Sun Apr 01 01:32:00 CST 2018, time=2018-04-01, status=1, ipAttribution=)]
    2018-06-10 zhouqu_8
  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417678, encodeId=144c141e678da, content=<a href='/topic/show?id=aada80351ae' target=_blank style='color:#2F92EE;'>#耐受性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80351, encryptionId=aada80351ae, topicName=耐受性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43843300457, createdName=Smile2681, createdTime=Sun Apr 01 01:32:00 CST 2018, time=2018-04-01, status=1, ipAttribution=)]
    2018-04-02 方舒

    学习

    0

  6. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417678, encodeId=144c141e678da, content=<a href='/topic/show?id=aada80351ae' target=_blank style='color:#2F92EE;'>#耐受性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80351, encryptionId=aada80351ae, topicName=耐受性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43843300457, createdName=Smile2681, createdTime=Sun Apr 01 01:32:00 CST 2018, time=2018-04-01, status=1, ipAttribution=)]
    2018-04-02 秀红

    学习了

    0

  7. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417678, encodeId=144c141e678da, content=<a href='/topic/show?id=aada80351ae' target=_blank style='color:#2F92EE;'>#耐受性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80351, encryptionId=aada80351ae, topicName=耐受性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43843300457, createdName=Smile2681, createdTime=Sun Apr 01 01:32:00 CST 2018, time=2018-04-01, status=1, ipAttribution=)]
    2018-04-01 大爰

    学习并分享!!

    0

  8. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417678, encodeId=144c141e678da, content=<a href='/topic/show?id=aada80351ae' target=_blank style='color:#2F92EE;'>#耐受性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80351, encryptionId=aada80351ae, topicName=耐受性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43843300457, createdName=Smile2681, createdTime=Sun Apr 01 01:32:00 CST 2018, time=2018-04-01, status=1, ipAttribution=)]
    2018-04-01 wzb521zf

    一起学习学习一下

    0

  9. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417678, encodeId=144c141e678da, content=<a href='/topic/show?id=aada80351ae' target=_blank style='color:#2F92EE;'>#耐受性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80351, encryptionId=aada80351ae, topicName=耐受性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43843300457, createdName=Smile2681, createdTime=Sun Apr 01 01:32:00 CST 2018, time=2018-04-01, status=1, ipAttribution=)]
    2018-04-01 gwc384
  10. 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在21世纪,炎性肠病已成为全球性疾病。今Lancet上发表一篇评估炎性肠病在全球范围的发病率和患病率的文章。

Aliment Pharmacol Ther:注意!炎性肠病患者过量使用类固醇

糖皮质激素是炎性肠病(IBD)诱导缓解的核心,但却是无效的维持性药物。2107年11月,发表在《Aliment Pharmacol Ther》的一项研究旨在确定英国门诊患者类固醇使用的标准并评估与过量暴露相关的因素。结果表明,14.9%的英国IBD患者发生类固醇依赖或过量(7.1%潜在可避免)。

Lancet:远程医疗可安全有效管理炎性肠病

炎性肠病是一种常见的慢性炎症性胃肠道疾病,传统情况下其严格和个性化的控制是一种挑战。2017年9月,发表在《Lancet》的一项实效、多中心、随机、对照试验调查了远程医疗管理炎性肠病对医疗资源的使用和患者报告的医疗质量的影响。研究结果表明远程医疗可安全有效管理炎性肠病。

Gut Microbes:炎性肠病患者合并艰难梭菌感染的肠道菌群特征

艰难梭菌感染是炎性肠病常见的并发症,并且常提示疾病预后不良。目前炎性肠病合并艰难梭菌感染患者的肠道微生态构成尚不明确。

Redox Biol:研究提示IDH2在结直肠癌预防中起到重要作用

IBD(炎性肠病)是包括UC(溃疡性结肠炎)和CD(克罗恩病)在内的慢性、复发性、免疫性、炎症性胃肠道疾病。临床表现腹泻、腹痛,甚至可有血便。溃疡性结肠炎是结肠黏膜层和黏膜下层连续性炎症,疾病通常先累及直肠,逐渐向全结肠蔓延,克罗恩病可累及全消化道,为非连续性全层炎症,最常累及部位为末端回肠、结肠和肛周。