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早期联合免疫抑制可降低长期克罗恩病的并发症:REACT 的事后分析。

Early Combined Immunosuppression Reduces Complications in Long-standing Crohn's Disease: A Post Hoc Analysis of REACT.

机构信息

Department of Gastroenterology, UMC Ljubljana, University of Ljubljana, Ljubljana, Slovenia; Alimentiv Inc, London, Ontario, Canada.

Alimentiv Inc, London, Ontario, Canada; Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada.

出版信息

Clin Gastroenterol Hepatol. 2022 Jan;20(1):236-238. doi: 10.1016/j.cgh.2020.12.019. Epub 2020 Dec 18.

Abstract

Crohn's disease (CD) can lead to bowel damage, stricturing, and obstruction thereby resulting in surgery and hospitalization. The Randomized Evaluation of an Algorithm for Crohn's Treatment (REACT) trial showed that early combined immunosuppression (ECI) with symptom-based treatment escalation for 24 months resulted in a lower risk of surgery, hospitalization, or CD-related complications compared with conventional management (CM). Treatment earlier in the disease course may be associated with reduced risk of complications compared with later initiation, although data are sparse. We performed a post hoc analysis of REACT to evaluate the impact of baseline disease duration on surgery, hospitalization, or CD-related complications in patients treated with ECI compared with CM.

摘要

克罗恩病(CD)可导致肠道损伤、狭窄和梗阻,从而导致手术和住院。随机评估克罗恩病治疗算法试验(REACT)表明,与常规治疗(CM)相比,基于症状的治疗升级进行 24 个月的早期联合免疫抑制(ECI)可降低手术、住院或与 CD 相关的并发症的风险。与晚期开始治疗相比,在疾病早期进行治疗可能与降低并发症风险相关,尽管数据较少。我们对 REACT 进行了事后分析,以评估与 CM 相比,接受 ECI 治疗的患者基线疾病持续时间对手术、住院或与 CD 相关并发症的影响。

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