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中重度溃疡性结肠炎患者的生活质量及其治疗影响:叙述性综述。

Quality of life in patients with moderate to severe ulcerative colitis and the impact of treatment: A narrative review.

机构信息

Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli, 8, Rome 00168, Italy; Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.

Medical Department, Inflammation and Immunology, Pfizer Italy.

出版信息

Dig Liver Dis. 2021 Jul;53(7):803-808. doi: 10.1016/j.dld.2021.03.002. Epub 2021 Mar 18.

Abstract

As a chronic inflammatory disease, ulcerative colitis has significant negative impact on the quality of life (QoL) of patients. Since the disease affects many aspects of QoL, comprising multiple domains, treatments that induce and maintain remission can provide benefits beyond hard clinical endpoints. Effective treatment of ulcerative colitis can restore QoL and return it to normal or near normal levels. Biological therapies have shown consistent improvement in the QoL of patients with ulcerative colitis during the induction phase, with benefits that are generally maintained in the long-term. Current medical treatment options broadly comprise aminosalicylates, corticosteroids, thiopurines, and calcineurin inhibitors, as well as biologic therapies. Conventional therapies do not always adequately control disease in a sizeable portion of patients, while anti-TNF antibodies are associated with several issues such as contraindications, intolerance, primary non-response, and loss of response in some patients. JAK inhibitors have been associated with clinical improvements in disease manifestations and long-term improvement in QoL outcomes. However, additional studies are needed to better understand the comparative effects of different treatments on QoL and patient preferences for therapy. Herein, the available evidence is reviewed regarding the impact of various treatments on QoL in patients with moderate to severe ulcerative colitis.

摘要

作为一种慢性炎症性疾病,溃疡性结肠炎对患者的生活质量(QoL)有显著的负面影响。由于该疾病影响 QoL 的多个方面,包含多个领域,因此能够诱导和维持缓解的治疗方法可以提供超越硬性临床终点的益处。有效的溃疡性结肠炎治疗可以恢复 QoL,并使其恢复到正常或接近正常水平。生物疗法在诱导期已显示出对溃疡性结肠炎患者 QoL 的持续改善,其益处通常在长期内得以维持。目前的治疗方案广泛包括氨基水杨酸类药物、皮质类固醇、硫嘌呤和钙调磷酸酶抑制剂以及生物疗法。常规疗法并不能使相当一部分患者的疾病得到充分控制,而抗 TNF 抗体与一些问题相关,如禁忌症、不耐受、原发性无反应以及部分患者的反应丧失。JAK 抑制剂与疾病表现的临床改善和 QoL 结局的长期改善相关。然而,需要进一步的研究来更好地了解不同治疗方法对 QoL 的比较效果和患者对治疗的偏好。本文回顾了关于各种治疗方法对中重度溃疡性结肠炎患者 QoL 影响的现有证据。

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