Otsuka Takafumi, Ooi Makoto, Tobimatsu Kazutoshi, Wakahara Chika, Watanabe Daisuke, Adachi Soichiro, Yasutomi Eiichiro, Yamairi Haruka, Ku Yuna, Yoshida Masaru, Hoshi Namiko, Kodama Yuzo
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Division of Metabolomics Research, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan.
Kobe J Med Sci. 2018 Dec 4;64(4):E140-E148.
BACKGROUND/AIMS: While some studies have shown that IFX and TAC exhibit similar efficacy against UC in the short-term, it is unclear which drug produces better long-term outcomes. In this study, we compared the long-term efficacy of IFX and TAC in patients with moderate to severe UC.
This retrospective study was conducted from 2009 to 2017. It included patients with no history of IFX or TAC treatment. We analyzed the clinical response and remission rates at 12 and 52 weeks, and colectomy-free and relapse-free survival were evaluated until the end of the study.
At 12 weeks, 94.4% and 77.8% of the patients in the IFX group (n = 18) had demonstrated clinical responses and clinical remission, respectively, whereas 72.7% of the patients in the TAC group (n = 11) exhibited clinical responses and clinical remission. The clinical response, clinical remission, and colectomy-free rates did not differ significantly between the groups. At 52 weeks, clinical responses and clinical remission had been achieved in 76.5% and 70.6% of the patients both in the IFX group, respectively. In the TAC group, clinical responses and clinical remission were achieved in 50.0% of patients. Relapse-free and colectomy-free survival were estimated significantly better in IFX group evaluated by Kaplan-Meier curves.
This study indicates that IFX and TAC produce similar short-term outcomes in UC patients, but IFX produces better long-term outcomes than TAC especially with avoidance of colectomy. Our data suggest that IFX therapy may be prioritized over TAC for the treatment of moderate to severe UC.
背景/目的：虽然一些研究表明英夫利昔单抗（IFX）和他克莫司（TAC）在短期内对溃疡性结肠炎（UC）的疗效相似，但尚不清楚哪种药物能产生更好的长期疗效。在本研究中，我们比较了IFX和TAC在中重度UC患者中的长期疗效。
本回顾性研究于2009年至2017年进行。纳入无IFX或TAC治疗史的患者。我们分析了12周和52周时的临床反应和缓解率，并评估了直至研究结束时的无结肠切除术生存率和无复发生存率。
在12周时，IFX组（n = 18）分别有94.4%和77.8%的患者表现出临床反应和临床缓解，而TAC组（n = 11）有72.7%的患者表现出临床反应和临床缓解。两组之间的临床反应、临床缓解和无结肠切除术率无显著差异。在52周时，IFX组分别有76.5%和70.6%的患者实现了临床反应和临床缓解。在TAC组中，50.0%的患者实现了临床反应和临床缓解。通过Kaplan-Meier曲线评估，IFX组的无复发和无结肠切除术生存率明显更好。
本研究表明，IFX和TAC在UC患者中产生相似的短期疗效，但IFX产生的长期疗效优于TAC，尤其是在避免结肠切除术方面。我们的数据表明，在治疗中重度UC时，IFX治疗可能优先于TAC。
