炎症性肠病患者改用皮下注射维多珠单抗治疗后停止治疗的结果。

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-10-16 eCollection Date: 2024-01-01 DOI:10.1177/17562848241290636
Péter Bacsur, Tamás Resál, Patrícia Sarlós, Ákos Iliás, Liza Dalma Sümegi, Diána Kata, Anett Dávid, Bernadett Farkas, Emese Ivány, Anita Bálint, Zsófia Bősze, Anna Fábián, Renáta Bor, Zoltán Szepes, Waqqas Afif, Talat Bessissow, Klaudia Farkas, Péter L Lakatos, Tamás Molnár
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引用次数: 0

摘要

背景:皮下注射维多珠单抗(s.c. VDZ)治疗炎症性肠病(IBD;溃疡性结肠炎(UC)、克罗恩病(CD))的可用性已通过临床试验得到证实,而真实世界的数据收集工作仍在进行中:我们的研究评估了从静脉注射制剂转为静脉注射VDZ治疗的有效性、安全性、患者偏好以及相关心理因素:设计:前瞻性多中心队列研究,包括从静脉注射 VDZ 转为静注 VDZ 治疗的 IBD 患者,评估时间为 52 周:方法:在基线和第52周时测量血清VDZ水平和C反应蛋白(CRP)。第12周时,对患者的满意度和心理特征进行问卷调查。主要结果是第52周时的药物持续率(停药原因包括反应消失(LOR)、不良事件、患者要求和其他原因),次要结果是临床无皮质类固醇缓解率(CSFR)和生化缓解率(BR;CRP ⩽ 5 mg/L)的变化、安全性问题、血清药物水平、患者偏好和心理特征:共评估了 70 名 IBD 患者(32 名 CD 患者,38 名 UC 患者;男女比例:41.4%;中位年龄:43.2 岁)。在 CD 组中,81.3% 患有 CSFR,65.6% 患有 BR,而在 UC 组中,71.7% 患有 CSFR,69.4% 患有 BR。总体而言,17.1%的患者在中位数26.2周(四分位间范围20-47周)后停止了静脉注射VDZ治疗。3/12 名停止治疗的患者出现了 LOR。此外,CSFR 和 BR 率保持稳定,而血清 VDZ 水平上升了 w52(p 结论):从静脉注射 VDZ 过渡到静脉滴注 VDZ 治疗是有效的,总体持续率与高血清药物水平有关,并且没有报告新的安全性问题。尽管诱导后静脉注射 VDZ 可以节省资源,但由于其配方已得到证实,一些患者仍坚持静脉注射 VDZ 治疗。
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Outcomes of treatment cessation after switching to subcutaneous vedolizumab treatment in inflammatory bowel diseases.

Background: The usability of subcutaneous vedolizumab (s.c. VDZ) treatment in inflammatory bowel diseases (IBD; ulcerative colitis (UC), Crohn's disease (CD)) has been proven via clinical trials while real-world data collection is ongoing.

Objectives: Our study evaluates the effectiveness, safety, patients' preferences, and psychological factors associated with s.c. VDZ treatment, after switching from intravenous (i.v.) formulation.

Design: Prospective, multicenter cohort study including IBD patients switching from i.v. VDZ to s.c. treatment and were evaluated over 52 weeks.

Methods: Serum VDZ levels and C-reactive protein (CRP) were measured at the baseline and w52. At w12, a questionnaire on the patient's satisfaction and psychological characteristics was administered. The primary outcome was the drug persistence rate (cessation was due to loss of response (LOR), adverse events, patient request, and other causes) at w52, while the secondary outcomes were the changes in the clinical corticosteroid-free remission (CSFR) and biochemical remission (BR; CRP ⩽ 5 mg/L) rates, safety issues, serum drug levels, patients' preferences, and psychological features.

Results: In total, 70 IBD patients were evaluated (32 CD patients, 38 UC patients; male/female ratio: 41.4%; median age: 43.2 years). In the CD group, 81.3% were in CSFR and 65.6% were in BR, while in the UC group, 71.7% were in CSFR and 69.4% were in BR. Overall, 17.1% of the patients ceased s.c. VDZ treatment after a median of 26.2 (interquartile range 20-47) weeks. LOR was registered in 3/12 ceased patients. In addition, CSFR and BR rates were stable, while serum VDZ levels increased by w52 (p < 0.001).

Conclusion: The transition from i.v. to s.c. VDZ treatment was effective, the overall persistence rate was associated with high serum drug levels, and no novel safety issues were reported. Although s.c. administration after induction can save resources, some patients still insisted on i.v. VDZ treatment, due to its proven formulation.

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