Ji Eun Na, Yong Eun Park, Jongha Park, Tae-Oh Kim, Jong Hoon Lee, Su Bum Park, Soyoung Kim, Seung Bum Lee
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引用次数: 0
摘要
许多研究比较了乌司替库单抗(UST)和抗肿瘤坏死因子药物[英夫利昔单抗(IFX)或阿达木单抗(ADA)]对中重度克罗恩病(CD)患者的疗效。本研究旨在比较UST、IFX和ADA的疗效,同时区分生物治疗无效和有生物治疗经验的患者。我们开展了一项从2012年到2023年的多中心回顾性研究,将患者分为生物免疫无经验组和生物免疫有经验组。我们评估了诱导治疗后的临床缓解率和临床结局,包括 CD 相关的住院治疗、肠切除术和维持治疗期间的停药。在214名生物免疫CD患者中,60人接受了UST治疗,108人接受了IFX治疗,46人接受了ADA治疗。在UST组和抗TNF药物组之间进行1:1倾向得分匹配后,每组分析了59名患者(IFX组45名,ADA组14名)。我们发现,UST 组、IFX 组和 ADA 组之间在生物免疫 CD 患者的临床缓解率(P = 0.071)、CD 相关住院率(P = 0.800)、肠切除率(P = 0.390)或停药率(P = 0.052)方面无明显差异。在生物经验丰富的 CD 患者中,UST 组有 35 人,抗肿瘤坏死因子药物组有 13 人,UST 组的停药风险(P = 0.004)低于抗肿瘤坏死因子药物组。这项研究表明,UST、IFX 和 ADA 对生物免疫缺陷 CD 患者同样有效,而对于生物免疫缺陷患者(大多曾接触过抗 TNF 药物),UST 可提供更好的药物耐久性。
Comparative real-world outcomes between ustekinumab, infliximab, and adalimumab in bio-naïve and bio-experienced Crohn’s disease patients: a retrospective multicenter study
Numerous studies have compared the efficacy of ustekinumab (UST) and anti-TNF agents [infliximab (IFX) or adalimumab(ADA)] in moderate to severe Crohn’s disease (CD) patients. This study aims to compare the efficacy of UST, IFX, and ADA while differentiating between bio-naïve and bio-experienced patients, which is an underexplored aspect, particularly in Asia. We conducted a retrospective multi-center study from 2012 to 2023, categorizing patients into bio-naïve and bio-experienced groups. We evaluated clinical remission rates after induction therapy and clinical outcomes, including CD-related hospitalization, intestinal resection, and drug discontinuation during maintenance therapy. Among the 214 bio-naïve CD patients, 60 received UST, 108 received IFX, and 46 received ADA. After 1:1 propensity score matching between UST and anti-TNF agents groups, 59 patients were analyzed in each group (45 in the IFX group and 14 in the ADA group). We found no significant differences in clinical remission rates (P = 0.071), CD-related hospitalization (P = 0.800), intestinal resection (P = 0.390), or drug discontinuation (P = 0.052) between the UST, IFX, and ADA groups in bio-naïve CD patients. In bio-experienced CD patients, with 35 in the UST group and 13 in the anti-TNF agents group, the UST group showed a lower risk of drug discontinuation (P = 0.004) than the anti-TNF agents group. This study suggests that UST, IFX, and ADA are equally effective in bio-naïve CD patients, while in bio-experienced patients, mostly with previous exposure to anti-TNF agents, UST may offer superior drug durability.
期刊介绍:
BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.