JCC:反应性试验后主动监测英夫利西单抗浓度可以获得更好的临床结局

2018-07-04 MedSci MedSci原创

反应性检测已成为炎症性肠病中应对英夫利昔单抗应答失效的新标准。最近的数据表明,主动的英夫利昔单抗监测与IBD的更好治疗结果相关。本项研究的目标是评估反应性试验后对IBD患者进行主动性英夫利昔单抗监测的远期效果。

背景和目标
反应性检测已成为炎症性肠病中应对英夫利昔单抗应答失效的新标准。最近的数据表明,主动的英夫利昔单抗监测与IBD的更好治疗结果相关。本项研究的目标是评估反应性试验后对IBD患者进行主动性英夫利昔单抗监测的远期效果。

方法
这是一项回顾性多中心队列研究,研究人员对2006年9月至2015年1月接受第一次反应性检测的英夫利昔单抗维持治疗的IBD患者进行了回顾性分析。并将患者分为A组[主动英利昔单抗监测后反应测试]和B组[反应单独测试]。所有患者随访至2015年12月。对治疗失败和IBD相关手术和住院进行了时间进行相关分析。治疗失败定义为由于反应丧失或严重不良事件导致药物停药。

结果
共有102名患者纳入本项研究,A组有70名患者,B组有52名患者。随访时间为2.7 [1.4-3.8 ]年。多重Cox回归分析发现,反应性试验后英夫利西单抗监测与治疗失败较少独立相关(危险比[HR] 0.15; 95%置信区间[CI] 0.05-0.51;p= 0.002),且IBD相关住院率较低[HR为0.18;95%CI 0.05-0.99;p= 0.007]。

结论
该研究表明,与单独的反应性测试相比,反应性测试后的主动英夫利昔单抗监测与更长久的药物疗效和更少的IBD相关住院相关。


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