Division of Gastroenterology, University of Pennsylvania, 3400 Civic Center Boulevard, 4th Floor, South Pavilion, Philadelphia, PA 19104, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Gastroenterol Clin North Am. 2017 Sep;46(3):589-601. doi: 10.1016/j.gtc.2017.05.012.
In patients with Crohn's disease (CD), anti-tumor necrosis factor (TNF) therapy is efficacious for the induction and maintenance of clinical remission, mucosal healing, reducing rates of surgery and hospitalizations, and improving health-related quality of life. The decision between anti-TNFs and anti-integrins as first-line treatment in CD depends on disease severity, safety concerns, and prescription coverage. Given the existing data on long-term outcomes and safety, anti-TNFs are often preferred to anti-integrins. Additional clinical experience and preferably prospective, head-to-head studies will be important to determine whether vedolizumab should be considered more often for first-line therapy in CD.
在克罗恩病（CD）患者中，抗肿瘤坏死因子（TNF）治疗在诱导和维持临床缓解、黏膜愈合、降低手术和住院率以及改善健康相关生活质量方面是有效的。在 CD 中，抗 TNF 与抗整合素作为一线治疗的选择取决于疾病严重程度、安全性问题和处方覆盖范围。鉴于长期结果和安全性的现有数据，抗 TNF 通常优先于抗整合素。额外的临床经验，最好是前瞻性的头对头研究，对于确定维得利珠单抗是否应更多地被考虑用于 CD 的一线治疗将是重要的。
