Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
Gastrozentrum Hirslanden, Hirslanden Private Clinic Group, Zurich, Switzerland.
United European Gastroenterol J. 2016 Feb;4(1):97-104. doi: 10.1177/2050640615593681. Epub 2015 Jul 3.
The published data about the efficacy of the intercellular adhesion molecule-1 (ICAM-1) antisense oligonucleotide termed alicaforsen in inflammatory bowel disease (IBD) is rather inconsistent. This case series analyzes its efficacy in chronic refractory pouchitis, after proctocolectomy.
We performed a retrospective analysis on all patients who had received at least one dose of alicaforsen for IBD at three referral centers in Switzerland. We assessed the drug's efficacy in patients treated for chronic refractory pouchitis, by comparing the clinical and/or endoscopic disease activity at baseline with a 2-3-month follow-up visit.
We identified 22 patients who had received at least one dose. Among them, 13 patients were being treated for chronic refractory pouchitis. These patients had a median age of 38.0 years (95% CI 21.0-69.0) and five were female (38.5%). The median time since pouch surgery was 102.5 months (95% CI 16.0-288.0), with a median pouchitis duration of 16.0 months (95% CI 4.0-216.0). At 2-3 months after therapy, clinical and endoscopic disease activity was significantly reduced (stool frequency 9.0 versus 6.0, the Pouchitis Disease Activity Index (PDAI) clinical subscore was 4.0 versus 1.0, and the endoscopic disease activity was 4.0 versus 2.0). Clinical improvement was achieved in 11 out of 13 pouchitis patients (84.6%); however, a relapse was observed in nine of these patients (81.8%). The median time from clinical improvement to relapse was 16 weeks (95% CI 9.0-23.0).
Alicaforsen seemed to be efficacious in inducing clinical and/or endoscopic improvement in chronic refractory pouchitis and may be a promising treatment alternative in those patients; however, given the high proportion of relapse, one 6-week course of alicaforsen may not be sufficient.
关于细胞间黏附分子-1（ICAM-1）反义寡核苷酸名为 alicaforsen 在炎症性肠病（IBD）中的疗效的已发表数据相当不一致。本病例系列分析了其在直肠结肠切除术后慢性难治性袋炎中的疗效。
我们对瑞士三个转诊中心接受至少一剂 alicaforsen 治疗 IBD 的所有患者进行了回顾性分析。我们通过比较基线时的临床和/或内镜疾病活动与 2-3 个月的随访来评估药物在治疗慢性难治性袋炎患者中的疗效。
我们确定了 22 名接受至少一剂治疗的患者。其中 13 名患者患有慢性难治性袋炎。这些患者的中位年龄为 38.0 岁（95%CI 21.0-69.0），其中 5 名为女性（38.5%）。从袋手术到中位时间为 102.5 个月（95%CI 16.0-288.0），袋炎持续时间为 16.0 个月（95%CI 4.0-216.0）。治疗后 2-3 个月，临床和内镜疾病活动明显减轻（粪便频率 9.0 与 6.0，Pouchitis 疾病活动指数（PDAI）临床亚评分 4.0 与 1.0，内镜疾病活动为 4.0 与 2.0）。13 名袋炎患者中有 11 名（84.6%）实现了临床改善；然而，其中 9 名患者（81.8%）出现了复发。从临床改善到复发的中位时间为 16 周（95%CI 9.0-23.0）。
Alicaforsen 似乎在诱导慢性难治性袋炎的临床和/或内镜改善方面有效，可能是这些患者的一种有前途的治疗选择；然而，鉴于复发率较高，6 周的 alicaforsen 疗程可能不足。
