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硫唑嘌呤治疗初治生物制剂的炎症性肠病患者内镜下黏膜愈合的发生率及预测因素:来自土耳其单一中心的10年真实世界经验

Rate and Predictors of Endoscopic Mucosal Healing in Biologic Naive Patients with Inflammatory Bowel Disease by Azathioprine Treatment: A Real World, 10 Years' Experience from a Single Centre in Turkey.

作者信息

Basaranoglu Metin, Ertan Atilla, Mathew Sanju, Najjar Sonia Michael, Ala Aftab, Demirbag Ali Eba, Senturk Hakan

机构信息

Department of Internal Medicine, Gastroenterology Division, Bezmialem Vakif University Faculty Hospital, Fatih, 34000, Istanbul, Turkey.

Gastroenterology and Gastrointestinal Surgery Divisions, Türkiye Yüksek Ihtisas Hospital, Sihhiye, 06010, Ankara, Turkey.

出版信息

J Gastrointest Dig Syst. 2016 Aug;6(4). doi: 10.4172/2161-069X.1000467. Epub 2016 Aug 31.

DOI:10.4172/2161-069X.1000467
PMID:29057149
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5648353/
Abstract

BACKGROUND

There is increasing evidence that endoscopic mucosal healing (EMH) is a key target in inflammatory bowel disease (IBD) therapy. However, there is limited evidence of EMH rates with conventional IBD therapy outside of Western population groups.

AİM: To evaluate the role of azathioprine (AZA) in inducing EMH in IBD patients.

METHODS

Patients with inflammatory bowel disease were evaluated in terms of endoscopic mucosal healing and the incidence of surgical interventions during the azathioprine treatment between 1995 to 2014.

RESULTS

A total of 120 inflammatory bowel disease patients were enrolled. Endoscopic mucosal healing was found in 37% patients with inflammatory bowel disease (42% in chronic ulcerative colitis and 33% in Crohn's disease). Male gender had a negative impact on the efficacy of azathioprine (P<0.05). Responder inflammatory bowel disease patients were older (age at the IBD diagnose) than the nonresponder (P<0.05). Azathioprine therapy reduced the number of the surgical interventions (P<0.05).

CONCLUSİON: We showed that azathioprine therapy significantly induced endoscopic mucosal healing in biologic naïve patients with active inflammatory bowel disease as well as decreasing the surgical interventions, with negative predictive factors identified by a younger age at IBD presentation and male gender.

摘要

背景

越来越多的证据表明,内镜下黏膜愈合(EMH)是炎症性肠病(IBD)治疗的关键目标。然而,在西方人群以外,关于传统IBD治疗的EMH率的证据有限。

目的

评估硫唑嘌呤(AZA)在诱导IBD患者EMH中的作用。

方法

对1995年至2014年接受硫唑嘌呤治疗期间的炎症性肠病患者进行内镜下黏膜愈合和手术干预发生率的评估。

结果

共纳入120例炎症性肠病患者。37%的炎症性肠病患者实现了内镜下黏膜愈合(慢性溃疡性结肠炎患者中为42%,克罗恩病患者中为33%)。男性对硫唑嘌呤的疗效有负面影响(P<0.05)。有反应的炎症性肠病患者比无反应的患者年龄更大(IBD诊断时的年龄)(P<0.05)。硫唑嘌呤治疗减少了手术干预的次数(P<0.05)。

结论

我们表明,硫唑嘌呤治疗能显著诱导初治的活动性炎症性肠病患者实现内镜下黏膜愈合,并减少手术干预,同时确定了IBD发病时年龄较小和男性为负面预测因素。

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Dig Dis. 2013;31(2):207-12. doi: 10.1159/000353370. Epub 2013 Sep 6.
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