Sakemi Ryosuke, Miyakawa Maki, Tanaka Hiroki, Nasuno Masanao, Motoya Satoshi, Tanuma Tokuma, Ishii Manabu, Yanagisawa Hideyuki, Yamashita Masaki, Toita Nariaki, Suzuki Ryo, Kobayashi Toshihisa, Nojima Masanori, So Suketo
Department of Gastroenterology, Tobata Kyoritsu Hospital, Kitakyushu.
IBD Center, Sapporo Kosei General Hospital.
Medicine (Baltimore). 2020 Nov 20;99(47):e23344. doi: 10.1097/MD.0000000000023344.
This study aimed to investigate the short-term effectiveness of adalimumab therapy in patients with ulcerative colitis (UC), especially its rapid response.This retrospective, multicenter, cohort study involved 7 institutes in Japan, compiling data from patients with UC who had received at least 1 induction dose of 160 mg of adalimumab between June 2013 and May 2017. Patients should have a Lichtiger clinical activity index score of ≥5 at the initial adalimumab administration. Remission was defined as clinical activity index score of ≤4, whereas response was defined as a reduction of ≥50% from the baseline value. Rapid responders are defined as patients who achieved response at 2 weeks.A total of 91 patients were included in this study: 37.4% and 45.1% achieved clinical response at 2 and 8 weeks, respectively, whereas clinical remission rates 12 weeks were 45.1%. Among the rapid responders, 82.4% achieved clinical remission at 12 weeks. Multivariate logistic regression analysis identified a higher platelet count as an independent prognostic factor for a higher rate of rapid response. Receiver operating characteristic curve showed that a platelet counts cutoff value of ≥312 × 10/L was associated with a rapid response.Approximately 40% of patients with UC showed a rapid response to adalimumab therapy after 2 weeks. Up to 80% of the rapid responders also achieved remission at 12 weeks. A higher platelet count was identified as an independent prognostic factor for a higher rapid response rate.
本研究旨在调查阿达木单抗治疗溃疡性结肠炎（UC）患者的短期疗效，尤其是其快速反应。这项回顾性、多中心队列研究涉及日本的7家机构，收集了2013年6月至2017年5月期间接受至少1次160mg阿达木单抗诱导剂量治疗的UC患者的数据。患者在首次使用阿达木单抗时Lichtiger临床活动指数评分应≥5。缓解定义为临床活动指数评分≤4，而反应定义为较基线值降低≥50%。快速反应者定义为在2周时达到反应的患者。本研究共纳入91例患者：分别有37.4%和45.1%的患者在2周和8周时达到临床反应，而12周时的临床缓解率为45.1%。在快速反应者中，82.4%的患者在12周时达到临床缓解。多因素逻辑回归分析确定较高的血小板计数是快速反应率较高的独立预后因素。受试者工作特征曲线显示血小板计数临界值≥312×10⁹/L与快速反应相关。约40%的UC患者在2周后对阿达木单抗治疗表现出快速反应。高达80%的快速反应者在12周时也实现了缓解。较高的血小板计数被确定为快速反应率较高的独立预后因素。
