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炎症性肠病患者的特征及未满足的需求,以及对选择新的生物治疗的决策:VEDO 研究的基线分析。

Profile of patients with inflammatory bowel disease in conjunction with unmet needs and decision-making for choosing a new biologic therapy: a baseline analysis of the VEDO-Study.

机构信息

Kompetenznetz Darmerkrankungen, Kiel, Germany.

Gastroenterology Practice, Saarbrücken, Germany.

出版信息

Int J Colorectal Dis. 2021 Nov;36(11):2445-2453. doi: 10.1007/s00384-021-03943-5. Epub 2021 May 8.

Abstract

PURPOSE

We characterized the profile of Crohn's disease (CD) or ulcerative colitis (UC) biologic-naïve patients (starting a new therapy with vedolizumab or TNFα-antagonists), their baseline disease activity predictors, and their perception of the quality of life (HRQoL).

METHODS

The VEDO-Study is a real-world study on the effectiveness of vedolizumab vs other biologics as induction and maintenance therapy for CD and UC. A total of 627 CD and 546 UC patients were enrolled from IBD-experienced centers across Germany. In both biologic-naïve vedolizumab (n=397) and anti-TNF (n=359) patients, CD and UC disease severity and HRQoL predictors were analyzed with logistic regression. The results were reported as odds ratio (OR) and 95% confidence interval (CI).

RESULTS

When compared to biologic-naïve anti-TNF patients, a first biological therapy with vedolizumab was considered for older CD patients, with a less complicated though longer disease course, and with a history of comorbidities. No differences in (unmet) needs were observed among patients with UC. The presence of extra-intestinal manifestations in biologic-naïve anti-TNF patients with CD (OR (95% CI): 3.83 (1.69-8.68)) and, in both biologic-naïve groups of patients with UC, stool frequency (2.00 (1.25-3.19); 1.82 (1.10-3.02), respectively) and rectal bleeding (2.24 (1.20-4.18); 1.92 (1.19-3.11), respectively) emerged as the most important predictors of disease severity, which in turn were also significantly associated with a worse HRQoL.

CONCLUSION

This study highlights the existence of unmet medical needs of patients with CD or UC, for whom a new biological therapy is planned as part of the VEDO-Study, which considerably impacts their HRQoL.

摘要

目的

我们描述了克罗恩病(CD)或溃疡性结肠炎(UC)生物初治患者(开始使用维得利珠单抗或 TNFα 拮抗剂的新疗法)的特征,他们的基线疾病活动预测因子,以及他们对生活质量(HRQoL)的感知。

方法

VEDO-Study 是一项关于维得利珠单抗与其他生物制剂作为 CD 和 UC 的诱导和维持治疗的有效性的真实世界研究。总共从德国有经验的 IBD 中心招募了 627 名 CD 和 546 名 UC 患者。在生物初治维得利珠单抗(n=397)和抗 TNF(n=359)患者中,采用逻辑回归分析 CD 和 UC 疾病严重程度和 HRQoL 预测因子。结果以比值比(OR)和 95%置信区间(CI)表示。

结果

与生物初治抗 TNF 患者相比,CD 患者中年龄较大、疾病过程较不复杂但较长、合并症较多的患者更倾向于接受第一次生物治疗。UC 患者之间的(未满足的)需求没有差异。CD 生物初治抗 TNF 患者中存在肠外表现(OR(95%CI):3.83(1.69-8.68)),以及在 UC 患者的生物初治两组中,粪便频率(2.00(1.25-3.19);1.82(1.10-3.02))和直肠出血(2.24(1.20-4.18);1.92(1.19-3.11))是疾病严重程度的最重要预测因子,而疾病严重程度反过来又与更差的 HRQoL 显著相关。

结论

本研究强调了 CD 或 UC 患者存在未满足的医疗需求,他们计划在 VEDO-Study 中进行新的生物治疗,这对他们的 HRQoL 有重大影响。

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