Clin Gastroenterology H: 监测炎症性肠病患者Vedolizumab谷浓度可以评估治疗预后

2018-12-15 MedSci MedSci原创

研究人员发现维多珠单抗(vedolizumab)的谷浓度与溃疡性结肠炎(UC)或克罗恩病(CD)患者的临床反应相关。然而,没有可靠的数据支持监测治疗患者的维多珠单抗低谷浓度的重要性。因此,本项研究探究了vedolizumab暴露与人群中的反应之间的相关性,旨在确定影响暴露和反应的因素。

背景与目的
研究人员发现维多珠单抗(vedolizumab)的谷浓度与溃疡性结肠炎(UC)或克罗恩病(CD)患者的临床反应相关。然而,没有可靠的数据支持监测治疗患者的维多珠单抗低谷浓度的重要性。因此,本项研究探究了vedolizumab暴露与人群中的反应之间的相关性,旨在确定影响暴露和反应的因素。

方法
研究人员对2015年9月1日至2016年10月1日在比利时鲁汶大学医院开始服用维多珠单抗治疗的179名IBD患者(66名UC和113名CD)进行了一项回顾性队列研究。在输注维多珠单抗至第30周之前测量维多珠单抗的血清浓度。主要观察终点包括内镜治愈(UC,Mayo内镜子评分≤1; CD,无溃疡),临床反应和生物反应或缓解(基于C反应蛋白的水平)并在第14周(对于UC患者)和第22周(对于CD患者)进行评估。进行逐步前向加法 - 后向消除建模方法以鉴定与维多珠单抗暴露和响应独立相关的因子。

结果
Vedolizumab谷浓度在第2周>30.0μg/ mL,第6周>24.0μg/ mL,维持治疗期间>14.0μg/ mL,与UC或CD患者获得有效终点的概率较高(P <0.05)。在维多珠单抗治疗开始时,较高的体重和更严重的疾病(基于高水平的C-反应蛋白和低水平的白蛋白和/或血红蛋白)与维多利珠单抗在30周时间内的较低谷浓度相关,并且实现粘膜愈合的概率较低(P <.05)。尽管UC的诊断并不是维多利珠单抗浓度较高的独立预测因素,但UC患者的CD粘连愈合率明显高于CD患者。

结论
在这一项对179例CD或UC患者的回顾性研究中,研究人员观察到维多珠单抗暴露与反应之间的相关性。这些发现支持监测vedolizumab谷浓度,以预测患者的预后。

原始出处:

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style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Mon Dec 17 01:54:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1544561, encodeId=c77e1544561f9, content=<a href='/topic/show?id=ac3d6549e75' target=_blank style='color:#2F92EE;'>#浓度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65497, encryptionId=ac3d6549e75, topicName=浓度)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16b213663040, createdName=12498974m55暂无昵称, createdTime=Mon Dec 17 01:54:00 CST 2018, time=2018-12-17, status=1, 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createdAvatar=null, createdBy=a9fa18776644, createdName=huangshifeng, createdTime=Mon Dec 17 01:54:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355483, encodeId=954b355483b1, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eb131638261, createdName=lietome24, createdTime=Sat Dec 15 11:47:38 CST 2018, time=2018-12-15, status=1, ipAttribution=)]
    2018-12-17 许安
  5. 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  6. 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  7. 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    2018-12-15 lietome24

    感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!

    0

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