Clin Gastroenterol H:停用英夫利昔单抗会增加UC患者复发风险

2016-10-08 xing.T MedSci原创

这个回顾性队列研究结果表明即使临床症状持续缓解的UC患者,停用英夫利昔单抗会增加UC患者复发风险,对复发患者重新开始治疗是有效和安全的。

英夫利昔单抗是一种安全、有效的治疗溃疡性结肠炎(UC)的药物。近日,消化病领域权威杂志《Clinical Gastroenterology and Hepatology》发表了一项多中心回顾性队列研究结果,旨在明确经英夫利昔单抗治疗持续缓解的患者能否停药。

在这项回顾性队列研究中,研究者收集了13级转诊炎症性肠病中心所有接受英夫利昔单抗治疗的UC患者(n=193)的病历资料。研究者比较了临床症状缓解至少12个月而停用英夫利昔单抗的UC患者(n = 111)和继续预定的英夫利昔单抗治疗的UC患者(对照组,n =82)的病程长短,并且分析比较了停药后,不同治疗策略患者UC复发的发生率、住院和手术情况,并评估重新服用英夫利昔单抗患者的响应率和不良影响的缓解情况。

在整个队列中,67例(34.7%)UC患者在随访期间复发。停药组患者的复发率(23.3人/100人/年)明显高于对照组患者与对照组(7.2人/100人/年),在单因素分析中(对数秩P<0.001;风险比为3.41;95%置信区间为1.88–6.20)以及多变量分析中(风险比为3.70;95%可信区间为2.02–6.77),两组间住院及手术率没有显著差异。


此外,停用英夫利昔单抗治疗后,硫嘌呤类药物似乎是最好的治疗方案(巯嘌呤治疗的复发率为15人/100人/年,巯嘌呤加对氨基水杨酸的复发率为27.4人/100人/年,仅对氨基水杨酸的复发率为31.2/100人/年;p=0.032)。重新服用英夫利昔单抗治疗,77.1%的患者对其有反应,51.4%患者出现缓解。然而,有17.1%患者出现输液反应,还有17.1%的患者报告发生其他不良事件。

这个回顾性队列研究表明:即使临床症状持续缓解的UC患者,停用英夫利昔单抗会增加UC患者复发风险,对复发患者重新开始治疗是有效和安全的。

原始出处:

Navarro Cortes,et al. Discontinuation of Infliximab in Patients With Ulcerative Colitis Is Associated With Increased Risk of Relapse: A Multinational Retrospective Cohort Study. clinical gastroenterology and hepatology 2016.

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    2017-07-08 hb2008ye
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    2017-04-13 许安
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1710938, encodeId=c7bd1e109387e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Jul 08 20:07:00 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905456, encodeId=5cf2190545698, content=<a href='/topic/show?id=0eb34259ea1' target=_blank style='color:#2F92EE;'>#复发风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42597, encryptionId=0eb34259ea1, topicName=复发风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ca20190, createdName=wushaoling, createdTime=Fri Oct 14 02:07:00 CST 2016, time=2016-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071679, encodeId=9f4b20e167956, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu Apr 13 21:07:00 CST 2017, time=2017-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064014, encodeId=32e3206401440, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Oct 17 23:07:00 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145888, encodeId=2c1e145888a1, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 22:22:02 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145651, encodeId=ef1d14565163, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Tue Oct 11 21:04:00 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145650, encodeId=bb0e14565012, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Tue Oct 11 21:03:52 CST 2016, time=2016-10-11, status=1, ipAttribution=)]
    2016-10-11 1e10c84am36(暂无匿称)

    好文章,受益

    0

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    2016-10-11 知难而进

    继续关注!

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1710938, encodeId=c7bd1e109387e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Jul 08 20:07:00 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905456, encodeId=5cf2190545698, content=<a href='/topic/show?id=0eb34259ea1' target=_blank style='color:#2F92EE;'>#复发风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42597, encryptionId=0eb34259ea1, topicName=复发风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ca20190, createdName=wushaoling, createdTime=Fri Oct 14 02:07:00 CST 2016, time=2016-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071679, encodeId=9f4b20e167956, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu Apr 13 21:07:00 CST 2017, time=2017-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064014, encodeId=32e3206401440, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Oct 17 23:07:00 CST 2016, time=2016-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145888, encodeId=2c1e145888a1, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 22:22:02 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145651, encodeId=ef1d14565163, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Tue Oct 11 21:04:00 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145650, encodeId=bb0e14565012, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Tue Oct 11 21:03:52 CST 2016, time=2016-10-11, status=1, ipAttribution=)]
    2016-10-11 知难而进

    谢谢分享!

    0

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