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阿达木单抗治疗溃疡性结肠炎:一项巴西多中心观察性研究的结果

ADALIMUMAB FOR ULCERATIVE COLITIS: RESULTS OF A BRAZILIAN MULTICENTER OBSERVATIONAL STUDY.

作者信息

Zacharias Patrícia, Damião Aderson Omar Mourão Cintra, Moraes Antonio Carlos, Teixeira Fábio Vieira, Ludvig Juliano Coelho, Nones Rodrigo Bremer, Saad-Hossne Rogerio, Sassaki Ligia Yukie, Silva Rosemary Pereira Lino da, Facchin Luiza, Olandoski Marcia, Kotze Paulo Gustavo

机构信息

Unidade de Cirurgia Colorretal, Hospital Universitário Cajuru, PUCPR, Curitiba, PR, Brazil.

Serviço de Gastroenterologia, USP, São Paulo, SP, Brazil.

出版信息

Arq Gastroenterol. 2017 Dec;54(4):321-327. doi: 10.1590/S0004-2803.201700000-51. Epub 2017 Oct 2.

Abstract

BACKGROUND

Adalimumab is a monoclonal antibody, tumor necrosis factor-alpha (TNFα) inhibitor that has efficacy for inducing and maintaining remission in moderate-to-severe ulcerative colitis. Real world studies with adalimumab in Latin American ulcerative colitis patients are scarce.

OBJECTIVE

To assess the clinical remission rates in induction and maintenance with adalimumab therapy in ulcerative colitis.

METHODS

Observational, multicenter and retrospective study on a case series of patients with moderate-to-severe ulcerative colitis under adalimumab therapy. The variables analyzed were: demographic data, previous infliximab status, concomitant drugs, the Montreal Classification, disease activity (Mayo score) at weeks 0, 8, 26 and 52, or until the last follow-up. Clinical remission was defined as a partial Mayo score ≤2 and Last observation carried forward (LOCF) and Non responder imputation (NRI) analysis were used.

RESULTS

Thirty-six patients were included in the study. With LOCF analysis, remission rates at weeks 8, 26 e 52 were of 41.7%, 47.2% and 47.2%, respectively. With NRI analysis, remission rates at weeks 8, 26 and 52 were of 41.7%, 41.7% and 27.8%, respectively.

CONCLUSION

Adalimumab was effective in the treatment of moderate-to-severe ulcerative colitis. Clinical remission was observed in approximately 40% of the patients at weeks 8 and 26, and in almost a quarter of the patients after 1 year of follow up.

摘要

背景

阿达木单抗是一种单克隆抗体,肿瘤坏死因子-α(TNFα)抑制剂,对诱导和维持中重度溃疡性结肠炎的缓解有效。在拉丁美洲溃疡性结肠炎患者中使用阿达木单抗的真实世界研究很少。

目的

评估阿达木单抗治疗溃疡性结肠炎诱导期和维持期的临床缓解率。

方法

对接受阿达木单抗治疗的中重度溃疡性结肠炎患者病例系列进行观察性、多中心回顾性研究。分析的变量包括:人口统计学数据、既往英夫利昔单抗使用情况、伴随用药、蒙特利尔分类、第0、8、26和52周或直至最后一次随访时的疾病活动度(梅奥评分)。临床缓解定义为部分梅奥评分≤2,并采用末次观察结转(LOCF)和无反应者插补(NRI)分析。

结果

36例患者纳入研究。采用LOCF分析,第8、26和52周的缓解率分别为41.7%、47.2%和47.2%。采用NRI分析,第8、26和52周的缓解率分别为41.7%、41.7%和27.8%。

结论

阿达木单抗对中重度溃疡性结肠炎治疗有效。在第8周和26周时,约40%的患者观察到临床缓解,随访1年后,近四分之一的患者达到临床缓解。

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