IBD: Ustekinumab剂量强化后克罗恩病治疗仍然失败的预测因子

2020-11-07 MedSci原创 MedSci原创

许多克罗恩病(CD)患者接受每隔8周(q8w)的标准ustekinumab剂量治疗反应应答,需要接受剂量强化至q4w或q6w。但是,剂量增加后成功或失败的危险因素尚不清楚。

背景

许多克罗恩病(CD)患者接受每隔8周(q8w)的标准ustekinumab剂量治疗反应应答,需要接受剂量强化至q4w或q6w。但是,剂量增加后成功或失败的危险因素尚不清楚。本项研究试图确定剂量增加后CD患者ustekinumab失败的预测因素。

 

 

方法

这是一项对2016年1月1日至2019年1月31日之间在三级转诊中心接受ustekinumab剂量强化治疗的成年CD患者的回顾性队列研究。研究人员回顾了患者的人口统计学资料,CD病史和实验室数据。主要结果是在强化后12个月内未达到无糖皮质激素的缓解(Harvey-Bradshaw指数<5)。评估的次要结果是剂量加大后开始新的生物治疗的时间。使用多变量logistic回归和Cox回归来确定这些结果的预测因子。

 

 

结果

研究人员纳入了123例接受ustekinumab剂量强化至q4w(n = 64),q5w(n = 1),q6w(n = 55)或q7w(n = 3)的患者。多变量logistic回归表明,肛周疾病,Harvey-Bradshaw指数和强化时使用阿片类药物与未能缓解相关。Cox回归表明,强化治疗时肛周疾病和皮质类固醇激素的使用与新生物制剂使用时间的缩短有关。

 

 

结论

CD剂量加大后,ustekinumab失败与肛周疾病,Harvey-Bradshaw指数,当前使用阿片类药物和当前使用皮质类固醇激素有关。

 

 

原始出处:

Rahul S Dalal. Et al. Predictors of Ustekinumab Failure in Crohn’s Disease After Dose Intensification. Inflammatory Bowel Diseases.2020.

 

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    2021-06-25 snf701207
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    2020-11-09 bnurmamat
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