IBD:英夫利昔单抗药物浓度较高可改善克罗恩病患者的血液和粪便中性粒细胞生物标志物的情况

2021-06-20 MedSci原创 MedSci原创

内镜评估仍然是监测克罗恩病 (CD) 患者治疗反应的金标准,然而,频繁地进行内窥镜检查进行疾病严重程度的评估会增加患者的经济和身体负担。

      内镜评估仍然是监测克罗恩病 (CD) 患者治疗反应的金标准,然而,频繁地进行内窥镜检查进行疾病严重程度的评估会增加患者的经济和身体负担。因此,替代侵入性检测的生物标志物的需求越发强烈,因为它可以避免频繁的侵入性手术。中性粒细胞衍生的粪便生物标志物钙卫蛋白 (FCP) 和乳铁蛋白 (LCT) 以及外周血中性粒细胞 CD64 表面受体 (nCD64) 是炎症性肠病 (IBD) 粘膜炎症的生物标志物。本项研究旨在确定与 FCP 缓解相关的 LCT 和 nCD64 的临界点,其次要目的是评估生化结果与英夫利昔单抗 (IFX) 谷浓度之间的关系。

 

      研究人员儿科克罗恩病 (CD) 队列研究中分析了患者在接受 IFX 治疗诱导前后的 FCP、LCT 和 nCD64水平差异。第14周 FCP <250 µg/g定义为生物缓解,临床反应定义为加权小儿克罗恩病活动指数 <12.5 或 Δ>17.5 。

 

      在56名CD患者中,ROC曲线分析显示当LCT <8.06时(接受者操作特征下面积 [AUROC],0.934,P < 0.001)和 nCD64 <6.12(AUROC,0.76,P = 0.02)是理想的第14周FCP生物标志物缓解的截断值。而IFX诱导治疗时的药物谷浓度>9.4 µg/mL (AUROC, 0.799, P = 0.002) 和 >11.5 µg/mL (AUROC, 0.835, P = 0.003)分别与 FCP <250 µg/g 和FCP <100  µg/g相关。研究人员还发现IFX药物谷浓度>5 µg/mL 的患者的 FCP 改善中位数为 90%,而水平 <5 µg/mL ( P = 0.024) 的FCP 改善中位数为35% ( P = 0.024)

图:英夫利昔单抗药物浓度较高可改善克罗恩病患者的血液和粪便中性粒细胞生物标志物

      本项研究为IFX诱导治疗后的生化缓解和治疗药物谷浓度水平确定了中性粒细胞粪便和血液生物标志物的截断值,可以为临床治疗提供一部分帮助。

 

 

原始出处:

Ruben J Colman. Et al. Achieving Target Infliximab Drug Concentrations Improves Blood and Fecal Neutrophil Biomarkers in Crohn’s Disease. Inflammatory Bowel Diseases.2021.

 

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    2021-11-07 hukaixun
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975235, encodeId=590f9e5235c9, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>加油( ¯ᒡ̱¯ )و, beContent=null, objectType=article, channel=null, level=null, likeNumber=367, replyNumber=1, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210620/6d80c079d511493bba30222968e58eae/859dcb53a82849fea94343533e83e1e1.jpg, createdBy=6d4e5529819, createdName=小胖子0806, createdTime=Sun Jun 20 21:53:12 CST 2021, time=2021-06-20, status=1, ipAttribution=)]
    2021-06-22 bnurmamat
  5. 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  6. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975235, encodeId=590f9e5235c9, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>加油( ¯ᒡ̱¯ )و, beContent=null, objectType=article, channel=null, level=null, likeNumber=367, replyNumber=1, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210620/6d80c079d511493bba30222968e58eae/859dcb53a82849fea94343533e83e1e1.jpg, createdBy=6d4e5529819, createdName=小胖子0806, createdTime=Sun Jun 20 21:53:12 CST 2021, time=2021-06-20, status=1, ipAttribution=)]
    2021-06-22 Homburg
  7. 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