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英夫利昔单抗与他克莫司治疗中重度溃疡性结肠炎的短期疗效比较。

A comparison of short-term therapeutic efficacy between infliximab and tacrolimus for moderate to severe ulcerative colitis.

作者信息

Yamagami Hirokazu, Nishida Yu, Nagami Yasuaki, Hosomi Shuhei, Yukawa Tomomi, Otani Koji, Tanaka Fumio, Taira Koichi, Kamata Noriko, Tanigawa Tetsuya, Shiba Masatsugu, Watanabe Toshio, Fujiwara Yasuhiro

机构信息

545-8585.

出版信息

Rom J Intern Med. 2017 Sep 26;55(3):151-157. doi: 10.1515/rjim-2017-0012.

Abstract

INTRODUCTION

Both infliximab (IFX) and tacrolimus (Tac) are effective for inducing clinical remission in patients with ulcerative colitis (UC). However, no randomized study has addressed the relative efficacies of IFX and Tac for patients with moderate to severe UC. This study aimed to conduct a retrospective study on the relative efficacy of IFX and Tac in patients with moderate to severe UC, using an inverse probability of treatment weighting (IPTW) technique to adjust background factors statistically.

METHODS

Between July 2009 and March 2016, data obtained from 122 patients with moderate to severe UC who were treated with either IFX (n = 58) or Tac (n = 64) were analyzed retrospectively. We compared the short-term therapeutic efficacy between the IFX group and Tac group using IPTW technique.

RESULTS

The clinical remission rate at 14 weeks after treatment was 37.9% (22/58) in the IFX group and 50% (32/64) in the Tac group, respectively. The efficacy of IFX and Tac for clinical remission rate was not different according to univariate (Odds ratio [OR] 1.64, 95% confidence interval [CI] 0.80-3.37 P = 0.18) and multivariate analyses (OR 2.19, 95% CI 0.85-5.61, P = 0.10). After the background and confounders factors were adjusted by using IPTW based on propensity score, the efficacy of IFX and Tac for clinical remission rate was not differed statistically (OR, 1.483; 95% CI, 0.581-3.785; P = 0.409) Conclusion. IFX and Tac have equivalent short-term efficacies for induction in patients with moderate to severe UC.

摘要

引言

英夫利昔单抗(IFX)和他克莫司(Tac)对诱导溃疡性结肠炎(UC)患者临床缓解均有效。然而,尚无随机研究探讨IFX和Tac对中重度UC患者的相对疗效。本研究旨在对IFX和Tac在中重度UC患者中的相对疗效进行回顾性研究,采用治疗权重逆概率(IPTW)技术对背景因素进行统计学调整。

方法

回顾性分析2009年7月至2016年3月期间122例接受IFX(n = 58)或Tac(n = 64)治疗的中重度UC患者的数据。我们使用IPTW技术比较IFX组和Tac组的短期治疗效果。

结果

治疗14周时,IFX组临床缓解率为37.9%(22/58),Tac组为50%(32/64)。单因素分析(优势比[OR] 1.64,95%置信区间[CI] 0.80 - 3.37,P = 0.18)和多因素分析(OR 2.19,95% CI 0.85 - 5.61,P = 0.10)显示,IFX和Tac对临床缓解率的疗效无差异。基于倾向评分使用IPTW对背景和混杂因素进行调整后,IFX和Tac对临床缓解率的疗效无统计学差异(OR,1.483;95% CI,0.581 - 3.785;P = 0.409)。结论:IFX和Tac对中重度UC患者诱导缓解具有等效的短期疗效。

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