JCC: 抗TNF药物浓度监测在术后克罗恩病作用

2018-06-02 MedSci MedSci原创

抗TNF治疗可以预防大多数患者的术后克罗恩病复发。本研究旨在确定阿达木单抗药代动力学,维持缓解和复发之间的关系。

背景
抗TNF治疗可以预防大多数患者的术后克罗恩病复发。本研究旨在确定阿达木单抗药代动力学,维持缓解和复发之间的关系。

方法
作为术后克罗恩病治疗研究的一部分,一些接受手术切除的患者术后接受阿达木单抗预防疾病复发。在这些患者中,在术后患者中分别于6,12和18个月测量血清和粪便阿达木单抗浓度和血清抗阿达木单抗抗体[AAAs]。术后6个月和18个月时评估克罗恩病活动指数[CDAI],C-反应蛋白[CRP]和粪便钙卫蛋白[FC]的水平。记录体重指数和吸烟状况。在6和/或18个月时进行结肠镜检查。

结果
本项研究纳入了52名患者[32名单药治疗和20名巯基嘌呤联合治疗]。内镜缓解与复发患者的阿达木单抗浓度没有显着差异[Rutgeerts≥i2] [9.98μg/ mL VS 8.43μg/ mL,p = 0.387]。阿达木单抗单一疗法的患者具有显着下阿达木单抗浓度[7.89微克/毫升]相比于患者联合疗法[11.725微克/毫升] [ p = 0.001]。可检测到的AAA患者的阿达木单抗浓度低于无AAA患者[3.59μg/ mL vs 12.0μg/ mL,p<0.001]。在粪便样品中未检测到阿达木单抗。与非肥胖患者相比,肥胖患者的阿达木单抗血清浓度较低[ p = 0.046]。

结论
对于大多数患者,术后使用阿达木单抗治疗预防内镜下复发的患者的阿达木单抗浓度处于治疗窗口内,发生复发的患者的阿达木单抗浓度与处于缓解期的患者相比并不显着降低。

原始出处:
Emily K Wright. Et al.Anti-TNF Therapeutic Drug Monitoring in Postoperative Crohn’s Disease. Journal of Crohn's and Colitis.2018.

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    2018-08-12 mfx808
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    2018-06-04 snowpeakxu
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    2018-06-02 虈亣靌

    学习了.获益匪浅.感谢分享

    0

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