L Bothorel, D Laharie, F Poullenot, E Gohier, C Chevrier, A Berger, F Zerbib, P Rivière
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引用次数: 0
摘要
背景:关于炎症性肠病(IBD)患者从静脉注射英夫利西单抗转为皮下注射英夫利西单抗和继续静脉注射英夫利西单抗的比较数据有限。本研究旨在比较皮下注射和静脉注射英夫利西单抗的持续性和耐受性,以及恢复静脉注射英夫利西单抗的患者的治疗效果:我们进行了一项回顾性单中心队列研究,涉及接受静脉注射英夫利西单抗维持治疗的 IBD 患者。每≥6周接受静脉注射剂量≤10 mg kg-1的临床缓解期患者可改用皮下注射英夫利西单抗。转换组与因拒绝转换而继续静脉注射英夫利西单抗的对照组进行了比较:中位随访59(46-67)周,28/282(10%)例患者停用皮下注射英夫利西单抗,1/78(1%)例患者停用静脉注射英夫利西单抗(P = 0.01);两组患者倾向得分匹配后,52周时的持续率分别为91%(95% CI 84-98)和100%(95% CI 100-100,P = 0.01)。在停用皮下注射英夫利昔单抗的28人中,27人恢复了静脉注射英夫利昔单抗,4人(占转换组的1%)永久停用了英夫利昔单抗:结论:从静脉注射英夫利西单抗转为皮下注射英夫利西单抗的治疗持续率较低。结论:从静脉注射转为皮下注射英夫利昔单抗可降低治疗的持续性,在皮下注射英夫利昔单抗耐受性差或复发的情况下,恢复静脉注射英夫利昔单抗是有效的。
Persistence of subcutaneous versus intravenous infliximab in a real-life cohort: A propensity-score matched comparative analysis.
Background: There is limited comparative data on patients with inflammatory bowel disease (IBD) switched from intravenous to subcutaneous infliximab and those continuing intravenously. This study aimed to compare the persistence and tolerance of subcutaneous and intravenous infliximab and the outcomes of patients resuming intravenous infliximab.
Methods: We conducted a retrospective single-centre cohort study involving IBD patients treated with maintenance intravenous infliximab. The switch to subcutaneous infliximab was offered to patients in clinical remission receiving an intravenous dose ≤ 10 mg kg-1 every ≥ 6 weeks. The switch group was compared to controls remaining on intravenous infliximab due to refusal of the switch.
Results: With a median follow-up of 59 (46-67) weeks, subcutaneous infliximab was discontinued in 28/282 (10 %) patients and intravenous infliximab in 1/78 (1 %) patient (p = 0.01); after propensity score-matching of the two cohorts, persistence rates at 52 weeks were respectively 91 % (95 % CI 84-98) and 100 % (95 % CI 100-100, p = 0.01). Among the 28 who discontinued subcutaneous infliximab, 27 resumed intravenous infliximab, with 4 (1 % of the switch group) who permanently stopped infliximab.
Conclusion: Switching from intravenous to subcutaneous infliximab led to a lower treatment persistance. In cases of poor tolerance or relapse under subcutaneous infliximab, resuming intravenous infliximab is effective.
期刊介绍:
Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD).
Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology.
Contributions consist of:
Original Papers
Correspondence to the Editor
Editorials, Reviews and Special Articles
Progress Reports
Image of the Month
Congress Proceedings
Symposia and Mini-symposia.