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阿达木单抗和英夫利昔单抗治疗初治的抗肿瘤坏死因子治疗的溃疡性结肠炎的疗效和患者偏好的前瞻性比较。

Prospective comparison of preference and efficacy of adalimumab and infliximab for treating ulcerative colitis naive to antitumor necrosis factor therapy.

作者信息

Mizoshita Tsutomu, Katano Takahito, Tanida Satoshi, Hirano Atsuyuki, Miyaki Tomokatsu, Ozeki Keiji, Suzuki Yuka, Sugimura Naomi, Kataoka Hiromi, Joh Takashi

机构信息

Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences Department of Gastroenterology, Nagoya City West Medical Center Department of Gastroenterology, Toyokawa City Hospital Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital Department of Gastroenterology, Nagoya Memorial Hospital, Nagoya, Japan.

出版信息

Medicine (Baltimore). 2017 Aug;96(32):e7800. doi: 10.1097/MD.0000000000007800.

Abstract

There have been few reports on 2 tumor necrosis factor alpha inhibitors, infliximab and adalimumab, with respect to patient preference and efficacy in ulcerative colitis (UC).We used questionnaires to evaluate the preference and reasons for drug choice between infliximab and adalimumab in UC patients naive to antitumor necrosis factor alpha therapy. We also analyzed the efficacy of infliximab and adalimumab prospectively and endoscopically before treatment and at 14 and 54 weeks.Of the 25 UC patients, infliximab and adalimumab were chosen by 10 (40%) and 15 (60%), respectively. Patients who favored infliximab considered "fear of syringes" (7/10, 70%) as the most important influencing factor, whereas patients who favored adalimumab considered "ease of administration" (10/15, 66.7%) and "time required for therapy" (10/15, 66.7%) as the most important factors. There were no statistical differences in remission induction and maintenance between the infliximab and adalimumab groups with regard to response, remission, mucosal healing, steroid-free, and steroid-free remission rates at weeks 14 and 54.The efficacy of adalimumab in remission induction and maintenance was equivalent to that of infliximab in UC patients naive to antitumor necrosis factor alpha therapy in this prospective study, but more patients preferred adalimumab.

摘要

关于两种肿瘤坏死因子α抑制剂英夫利昔单抗和阿达木单抗,在溃疡性结肠炎(UC)患者偏好及疗效方面的报道较少。我们采用问卷调查评估了初治抗肿瘤坏死因子α治疗的UC患者对英夫利昔单抗和阿达木单抗的用药偏好及选择原因。我们还前瞻性地分析了英夫利昔单抗和阿达木单抗在治疗前、第14周和第54周时的疗效,并进行了内镜检查。25例UC患者中,分别有10例(40%)选择了英夫利昔单抗,15例(60%)选择了阿达木单抗。倾向于英夫利昔单抗的患者认为“害怕打针”(7/10,70%)是最重要的影响因素,而倾向于阿达木单抗的患者认为“给药方便”(10/15,66.7%)和“治疗所需时间”(10/15,66.7%)是最重要的因素。在第14周和第54周时,英夫利昔单抗组和阿达木单抗组在缓解诱导和维持方面,在反应、缓解、黏膜愈合、无类固醇及无类固醇缓解率上无统计学差异。在这项前瞻性研究中,对于初治抗肿瘤坏死因子α治疗的UC患者,阿达木单抗在缓解诱导和维持方面的疗效与英夫利昔单抗相当,但更多患者更喜欢阿达木单抗。

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