NEJM:Ustekinumab用于中重度溃疡性结肠炎

2019-09-26 MedSci MedSci原创

白细胞介素-12和白细胞介素-23的P40亚单位的拮抗剂Ustekinumab作为诱导和维持手段治疗溃疡性结肠炎的疗效尚不清楚。 近日研究人员评价了Ustekinumab作为8周诱导治疗和44周维持治疗在中重度溃疡性结肠炎患者中的疗效。总共961名患者随机接受静脉注射诱导剂量Ustekinumab(130毫克,n=320)或体重范围剂量(接近每公斤体重6毫克计,n=322)或安慰剂(n=31

白细胞介素-12和白细胞介素-23的P40亚单位的拮抗剂Ustekinumab作为诱导和维持手段治疗溃疡性结肠炎的疗效尚不清楚。

近日研究人员评价了Ustekinumab作为8周诱导治疗和44周维持治疗在中重度溃疡性结肠炎患者中的疗效。总共961名患者随机接受静脉注射诱导剂量Ustekinumab(130毫克,n=320)或体重范围剂量(接近每公斤体重6毫克计,n=322)或安慰剂(n=319)。在静脉注射ustekinumab后8周对诱导治疗有反应的患者,随机接受皮下注射90毫克ustekinumab(每12周一次,n=172)或每8周(n=176)或安慰剂(175例)。诱导试验(第8周)和维持试验(第44周)的主要终点是临床缓解(定义为在Mayo量表上的总分≤2)。

在接受剂量为130毫克(15.6%)或每公斤6毫克(15.5%)ustekinumab静脉注射的患者中,在第8周有临床缓解的患者的百分比显著高于接受安慰剂的患者(5.3%)。在对ustekinumab诱导疗法有反应并接受第二次随机化治疗的患者中,每12周(38.4%)或每8周(43.8%)服用90 mg ustekinumab的患者中,44周临床缓解患者的百分比显著高于安慰剂组(24.0%)。ustekinumab的严重不良事件发生率与安慰剂相似。在52周的接触中,在接受ustekinumab治疗的825例患者中,有两例死亡(急性呼吸窘迫综合征和食管静脉曲张出血),7例癌症(1例前列腺癌、1例结肠癌、1例肾乳头状癌、1例直肠癌和3例非黑色素瘤皮肤癌),在319例接受安慰剂治疗的患者中,没有死亡但有1例癌症(睾丸癌)。

研究认为Ustekinumab可有效诱导和维持中度至重度溃烂性结肠炎患者的临床缓解。

原始出处:

Bruce E. Sands et al. Ustekinumab as Induction and Maintenance Therapy for Ulcerative Colitis. N Engl J Med, September 26, 2019.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1642715, encodeId=940e1642e1555, content=<a href='/topic/show?id=39071820109' target=_blank style='color:#2F92EE;'>#ustekinumab#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18201, encryptionId=39071820109, topicName=ustekinumab)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ae023003775, createdName=12498f1em15(暂无昵称), createdTime=Tue Jul 07 02:51:00 CST 2020, time=2020-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1695113, encodeId=513216951130c, content=<a href='/topic/show?id=c76e6645438' target=_blank style='color:#2F92EE;'>#溃疡性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66454, encryptionId=c76e6645438, topicName=溃疡性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=787129789891, createdName=nymo, createdTime=Wed Jun 10 04:51:00 CST 2020, time=2020-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1912217, encodeId=e9cf191221eae, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Wed Aug 19 00:51:00 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373248, encodeId=eef43e3248e1, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Fri Sep 27 07:16:10 CST 2019, time=2019-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034964, encodeId=2695103496451, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Sep 26 21:51:00 CST 2019, time=2019-09-26, status=1, ipAttribution=)]
    2020-06-10 nymo
  3. [GetPortalCommentsPageByObjectIdResponse(id=1642715, encodeId=940e1642e1555, content=<a href='/topic/show?id=39071820109' target=_blank style='color:#2F92EE;'>#ustekinumab#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18201, encryptionId=39071820109, topicName=ustekinumab)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ae023003775, createdName=12498f1em15(暂无昵称), createdTime=Tue Jul 07 02:51:00 CST 2020, time=2020-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1695113, encodeId=513216951130c, content=<a href='/topic/show?id=c76e6645438' target=_blank style='color:#2F92EE;'>#溃疡性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66454, encryptionId=c76e6645438, topicName=溃疡性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=787129789891, createdName=nymo, createdTime=Wed Jun 10 04:51:00 CST 2020, time=2020-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1912217, encodeId=e9cf191221eae, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Wed Aug 19 00:51:00 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373248, encodeId=eef43e3248e1, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Fri Sep 27 07:16:10 CST 2019, time=2019-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034964, encodeId=2695103496451, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Sep 26 21:51:00 CST 2019, time=2019-09-26, status=1, ipAttribution=)]
    2020-08-19 snf701207
  4. [GetPortalCommentsPageByObjectIdResponse(id=1642715, encodeId=940e1642e1555, content=<a href='/topic/show?id=39071820109' target=_blank style='color:#2F92EE;'>#ustekinumab#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18201, encryptionId=39071820109, topicName=ustekinumab)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ae023003775, createdName=12498f1em15(暂无昵称), createdTime=Tue Jul 07 02:51:00 CST 2020, time=2020-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1695113, encodeId=513216951130c, content=<a href='/topic/show?id=c76e6645438' target=_blank style='color:#2F92EE;'>#溃疡性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66454, encryptionId=c76e6645438, topicName=溃疡性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=787129789891, createdName=nymo, createdTime=Wed Jun 10 04:51:00 CST 2020, time=2020-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1912217, encodeId=e9cf191221eae, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Wed Aug 19 00:51:00 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373248, encodeId=eef43e3248e1, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Fri Sep 27 07:16:10 CST 2019, time=2019-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034964, encodeId=2695103496451, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Sep 26 21:51:00 CST 2019, time=2019-09-26, status=1, ipAttribution=)]
    2019-09-27 thm112988

    0

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    2019-09-26 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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