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类固醇依赖型溃疡性结肠炎的优化管理

Optimal management of steroid-dependent ulcerative colitis.

作者信息

Khan Hafiz M Waqas, Mehmood Faisal, Khan Nabeel

机构信息

Department of Medicine, King Edward Medical University, Lahore, Pakistan.

Section of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia VA Medical Center, Philadelphia, PA, USA.

出版信息

Clin Exp Gastroenterol. 2015 Nov 12;8:293-302. doi: 10.2147/CEG.S57248. eCollection 2015.

Abstract

Ulcerative colitis (UC) is a chronic inflammatory condition that is variable in both extent and severity of disease as well as response to therapy. Corticosteroids (CSs) were the first drugs used in the management of UC and are still used for induction of remission. However, because of their extensive side-effect profile, they are not utilized for maintenance of remission. In view of this, CS-free remission has become an important end point while evaluating therapeutic agents used in the management of UC. This review highlights the results of various studies conducted to evaluate the efficacy of different medications to attain CS-free remission in the setting of active UC. The drugs reviewed include established agents such as thiopurines, methotrexate, infliximab, adalimumab, vedolizumab, golimumab, and newer experimental agents, and if all else fails, colectomy will be performed. The efficacy of these drugs is evaluated individually. Our aim is to provide a synopsis of the work done in this field to date.

摘要

溃疡性结肠炎(UC)是一种慢性炎症性疾病,其疾病范围、严重程度以及对治疗的反应各不相同。皮质类固醇(CSs)是最早用于治疗UC的药物,目前仍用于诱导缓解。然而,由于其广泛的副作用,它们不用于维持缓解。鉴于此,无皮质类固醇缓解已成为评估用于治疗UC的治疗药物时的一个重要终点。本综述重点介绍了为评估不同药物在活动性UC患者中实现无皮质类固醇缓解的疗效而开展的各项研究结果。所综述的药物包括硫唑嘌呤、甲氨蝶呤、英夫利昔单抗、阿达木单抗、维多珠单抗、戈利木单抗等已确立的药物以及新型实验性药物,若其他所有方法均失败,则将进行结肠切除术。这些药物的疗效将分别进行评估。我们的目的是对该领域迄今为止所做的工作进行概述。

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