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优特克单抗治疗克罗恩病:来自西西里岛炎症性肠病网络的真实世界结果

Ustekinumab in Crohn's disease: Real-world outcomes from the Sicilian network for inflammatory bowel diseases.

作者信息

Viola Anna, Muscianisi Marco, Macaluso Fabio S, Ventimiglia Marco, Cappello Maria, Privitera Antonino C, Magnano Antonio, Pluchino Dario, Magrì Giovanni, Ferracane Concetta, Mocciaro Filippo, Garufi Serena, Giuffrida Enrica, Costantino Giuseppe, Fiocco Gabriele, Grova Mauro, Guida Laura, Alibrandi Angela, Orlando Ambrogio, Fries Walter

机构信息

Gastroenterology and Inflammatory Bowel Disease Unit A.O.U. Policlinico "G. Martino" Messina Italy.

Inflammatory Bowel Disease Unit, A.O.O.R. "Villa Sofia-Cervello" Palermo Italy.

出版信息

JGH Open. 2021 Feb 2;5(3):364-370. doi: 10.1002/jgh3.12502. eCollection 2021 Mar.

Abstract

BACKGROUND AND AIM

Ustekinumab is approved in Europe for the treatment of moderate to severe Crohn's disease (CD). Italian real-life data are scarce, so the aim of this study was to assess the effectiveness and safety of ustekinumab in an Italian cohort of CD patients.

METHODS

Data of patients with CD who started using ustekinumab were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Disease. Primary end-points were steroid-free clinical remission at 8, 24, and 52 weeks of therapy and reduction of C-reactive protein. Secondary end-points were treatment response, treatment persistence at 12 months, and safety.

RESULTS

A total of 131 patients (males 56%; mean age 46 years 15) were included. All patients were biologics experienced except for one. At 24 and 52 weeks, 40% and 43% of patients achieved steroid-free clinical remission, and 64% and 62% had clinical response, respectively. At the end of follow-up, there was a significant reduction of steroid use ( = 0.012) and of the Harvey-Bradshaw Index ( = 0.001). The probability of persistence in therapy with ustekinumab after 12 months of treatment was 89%. The only factor associated with discontinuation was older age.

CONCLUSIONS

Data from our real-life cohort of treatment-refractory CD patients suggest the satisfactory effectiveness and safety profile of ustekinumab.

摘要

背景与目的

优特克单抗在欧洲被批准用于治疗中度至重度克罗恩病(CD)。意大利的真实数据稀缺,因此本研究的目的是评估优特克单抗在一组意大利CD患者中的有效性和安全性。

方法

从西西里岛炎症性肠病网络队列中提取开始使用优特克单抗的CD患者数据。主要终点是治疗8周、24周和52周时无类固醇临床缓解以及C反应蛋白降低。次要终点是治疗反应、12个月时的治疗持续性和安全性。

结果

共纳入131例患者(男性占56%;平均年龄46岁15)。除1例患者外,所有患者均有生物制剂使用经验。在24周和52周时,分别有40%和43%的患者实现无类固醇临床缓解,64%和62%的患者有临床反应。随访结束时,类固醇使用量(P = 0.012)和哈维-布拉德肖指数(P = 0.001)显著降低。治疗12个月后继续使用优特克单抗治疗的概率为89%。与停药相关的唯一因素是年龄较大。

结论

我们对难治性CD患者的真实队列数据表明优特克单抗具有令人满意的有效性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/7936616/86fcabc19e40/JGH3-5-364-g001.jpg

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