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溃疡性结肠炎：以新标准超越症状的 STRIDE。

Ulcerative colitis: STRIDE-ing beyond symptoms with new standards.

机构信息

Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.

Medicine ACP, SingHealth Duke-NUS Academic Medical Centre, Singapore.

出版信息

Singapore Med J. 2024 Feb 1;65(2):99-105. doi: 10.11622/smedj.2021173. Epub 2021 Nov 26.

DOI:10.11622/smedj.2021173
PMID:34823326
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10942141/
Abstract

The landscape of ulcerative colitis has changed in the last two decades. Advancements in pharmacotherapeutics have heralded the introduction of new treatment options, with many agents in development. Better clinical outcomes are seen with tighter disease control, made possible with greater understanding of inflammatory pathways and their blockade with drugs. There has been a resultant shift in treatment targets, beyond symptoms to endoscopic and histological healing. Controlling the burden of disease activity also lowers the risk of developing colorectal cancer. Colorectal cancer screening now requires the use of dye-based agents and high-definition colonoscopy to improve the detection of colonic neoplasms.

摘要

在过去的二十年中，溃疡性结肠炎的治疗格局发生了变化。药物治疗的进步预示着新的治疗选择的出现，许多药物正在研发中。通过更深入地了解炎症途径及其药物阻断作用，更好地控制疾病，从而实现更紧密的疾病控制，从而改善临床结果。治疗目标也从症状转变为内镜和组织学愈合。控制疾病活动的负担也降低了发展为结直肠癌的风险。目前需要使用基于染料的药物和高清结肠镜检查来提高结直肠肿瘤的检出率，以进行结直肠癌筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/a30e12326adc/SMJ-65-99-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/61f98b7f1296/SMJ-65-99-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/b46ac5624474/SMJ-65-99-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/b3d43311f731/SMJ-65-99-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/4a8e1f48a5ba/SMJ-65-99-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/a30e12326adc/SMJ-65-99-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/61f98b7f1296/SMJ-65-99-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/b46ac5624474/SMJ-65-99-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/b3d43311f731/SMJ-65-99-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/4a8e1f48a5ba/SMJ-65-99-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f42d/10942141/a30e12326adc/SMJ-65-99-g005.jpg

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本文引用的文献

1
Ozanimod as Induction and Maintenance Therapy for Ulcerative Colitis.奥扎莫德用于溃疡性结肠炎的诱导缓解和维持治疗。
N Engl J Med. 2021 Sep 30;385(14):1280-1291. doi: 10.1056/NEJMoa2033617.
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AGA Clinical Practice Update on Endoscopic Surveillance and Management of Colorectal Dysplasia in Inflammatory Bowel Diseases: Expert Review.AGA 临床实践更新：炎症性肠病中结直肠发育不良的内镜监测和管理：专家综述。
Gastroenterology. 2021 Sep;161(3):1043-1051.e4. doi: 10.1053/j.gastro.2021.05.063.
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Clinical Value of Fecal Calprotectin in Predicting Mucosal Healing in Patients With Ulcerative Colitis.
粪便钙卫蛋白在预测溃疡性结肠炎患者黏膜愈合中的临床价值
Front Med (Lausanne). 2021 Aug 3;8:679264. doi: 10.3389/fmed.2021.679264. eCollection 2021.
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Filgotinib as induction and maintenance therapy for ulcerative colitis (SELECTION): a phase 2b/3 double-blind, randomised, placebo-controlled trial.Filgotinib 作为溃疡性结肠炎的诱导缓解和维持治疗（SELECTION）：一项 2b/3 期双盲、随机、安慰剂对照试验。
Lancet. 2021 Jun 19;397(10292):2372-2384. doi: 10.1016/S0140-6736(21)00666-8. Epub 2021 Jun 3.
5
Acceptability of a 'treat to target' approach in inflammatory bowel disease to patients in clinical remission.炎症性肠病“达标治疗”方法对临床缓解期患者的可接受性。
Frontline Gastroenterol. 2020 Jan 24;12(1):30-38. doi: 10.1136/flgastro-2019-101366. eCollection 2021.
6
STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD.STRIDE-II：炎症性肠病（STRIDE）国际研究组织（IOIBD）治疗靶点选择更新：确定炎症性肠病靶向治疗策略的治疗目标。
Gastroenterology. 2021 Apr;160(5):1570-1583. doi: 10.1053/j.gastro.2020.12.031. Epub 2021 Feb 19.
7
Efficacy of Upadacitinib in a Randomized Trial of Patients With Active Ulcerative Colitis.乌帕替尼在活动性溃疡性结肠炎患者随机试验中的疗效。
Gastroenterology. 2020 Jun;158(8):2139-2149.e14. doi: 10.1053/j.gastro.2020.02.030. Epub 2020 Feb 22.
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Clin Gastroenterol Hepatol. 2020 Sep;18(10):2179-2191.e6. doi: 10.1016/j.cgh.2020.01.008. Epub 2020 Jan 13.
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Expert Opin Biol Ther. 2020 Apr;20(4):399-406. doi: 10.1080/14712598.2020.1697227. Epub 2019 Nov 27.
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N Engl J Med. 2019 Sep 26;381(13):1215-1226. doi: 10.1056/NEJMoa1905725.