Gastroenterology:依据临床症状是活动性克罗恩病患者维持治疗期间更有效的英夫利昔单抗给药方法

2018-01-09 zhangfan MedSci原创

研究认为,对于活动性克罗恩病患者,依据症状、生物标志物和血清药物浓度提高英夫利昔单抗剂量的治疗方法,较单纯的依据临床指标剂量提升方法不会增加无糖皮质激素临床缓解率

英夫利昔单抗联合免疫调节治疗是最常见的克罗恩病(CD)治疗手段。药物血清浓度高于治疗阈值时患者可获得最好治疗结果。近日研究人员考察了治疗性药物监测(TDM)以维持英利昔单抗浓度高于3μg/ml对临床和内镜缓解率的影响。

研究招募了122名未进行过生物治疗的活动性CD患者,患者接受14周的英夫利昔单抗联合免疫调节诱导治疗。随后患者随机接受3个剂量提升方案的英夫利昔单抗维持治疗:依据临床症状、生物标志物分析以及血清英夫利昔单抗浓度分析,以2.5mg/kg的幅度逐渐提高英夫利昔单抗的治疗剂量(DIS1组);同样的指标,最终剂量为5-10 mg/kg (DIS2组);依据临床症状将剂量提高至10mg/kg(对照组)。在基线、2、4、6、12以及14周考察患者的CD活性指数评分、C反应蛋白水平、粪便钙卫蛋白水平和血清英夫利昔单抗浓度。研究的主要终点是22-54周中持续性无糖皮质激素临床缓解(CD活性指数<150)。

各组主要终点达标率如下:DIS1组,15/45(33%);DIS2组10/37(27%);对照组16/40(40%,P=0.50)。

研究认为,对于活动性克罗恩病患者,依据症状、生物标志物和血清药物浓度提高英夫利昔单抗剂量的治疗方法,较单纯的依据临床指标剂量提升方法不会增加无糖皮质激素临床缓解率。

原始出处:


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    2018-03-25 许安
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content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, 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=Thu Jan 11 01:45:00 CST 2018, time=2018-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=277234, encodeId=84fa2e723430, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Wed Jan 10 16:45:02 CST 2018, time=2018-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=277174, encodeId=626e2e7174be, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=80d11516357, createdName=139****0239, createdTime=Wed Jan 10 12:14:28 CST 2018, time=2018-01-10, status=1, ipAttribution=)]
    2018-01-15 虈亣靌

    不错的文章值得推荐

    0

  8. 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  9. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=277174, encodeId=626e2e7174be, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=80d11516357, createdName=139****0239, createdTime=Wed Jan 10 12:14:28 CST 2018, time=2018-01-10, status=1, ipAttribution=)]
    2018-01-10 cscdliu

    学习了.谢谢

    0

  10. 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    2018-01-10 139****0239

    henhao

    0

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PLos One:英夫利昔单抗用于类风湿性关节炎的手和腕部磁共振成像

DCE-MRI和RAMRIS同样敏感,并对英夫利昔单抗的抗炎作用有响应。

Lancet Gastroen Hepatol:克罗恩病——腹腔镜切除术 vs 英夫利昔单抗

研究认为,对于常规治疗失败的非狭窄,回盲部克罗恩病患者,腹腔镜切除术是有效的英夫利昔单抗治疗替代手段

J Gastroen Hepatol:溃疡性结肠炎患者英夫利昔单抗治疗与结核风险

研究表明,在结核病高发的印度,英夫利昔单抗治疗溃疡性结肠炎导致的结核病发病率并不严重

Neurology:英夫利昔单抗治疗神经系统肉瘤

研究发现,大部分神经肉瘤患者在接受英夫利昔单抗治疗出现影像学以及临床症状缓解。对于部分先前免疫抑制剂治疗失败的患者,英夫利昔单抗也表现出较好的治疗效果