霉酚酸酯在炎症性肠病中的真实世界应用：来自ENEIDA注册研究的结果。

Real-world use of mycophenolate mofetil in inflammatory bowel disease: Results from the ENEIDA registry.

作者信息

Hernández-Camba A, Arranz L, Vera I, Carpio D, Calafat M, Lucendo A J, Taxonera C, Marín S, Garcia M J, Marín G Suris, Rodríguez E Sánchez, Carbajo A Y, De Castro M L, Iborra M, Martin-Cardona A, Rodríguez-Lago I, Busquets D, Bertoletti F, Ausín M Sierra, Tardillo C, Malaves J Huguet, Bujanda L, Castaño A, Domènech E, Ramos L

机构信息

Hospital Universitario Nuestra Señora de la Candelaria, Gastroenterology Dept., Santa Cruz de Tenerife, Spain.

出版信息

Dig Liver Dis. 2022 May;54(5):635-641. doi: 10.1016/j.dld.2021.10.002. Epub 2021 Nov 30.

DOI:10.1016/j.dld.2021.10.002

PMID:34862115

Abstract

BACKGROUND

Studies to evaluate the use of mycophenolate mofetil (MMF) in inflammatory bowel disease (IBD) are limited after the appearance of biological treatments.

AIMS

Our primary objective was to evaluate the effectiveness and safety of MMF in IBD.

METHODS

IBD patients who had received MMF were retrieved from the ENEIDA registry. Clinical activity as per the Harvey-Bradshaw Index (HBI), partial Mayo score (pMS), physician global assessment (PGA) and C-reactive protein (CRP) were reviewed at baseline, at 3 and 6 months, and at final follow-up. Adverse events and causes of treatment discontinuation were documented.

RESULTS

A total of 83 patients were included (66 Crohn's disease, 17 ulcerative colitis), 90% of whom had previously received other immunosuppressants. In 61% of patients systemic steroids were used at initiation of MMF, and in 27.3% biological agents were co-administered with MMF. Overall clinical effectiveness was observed in 64.7% of the population. At the end of treatment, 45.6% and 19.1% of subjects showed remission and clinical response, respectively. MMF treatment was maintained for a median of 28.9 months (IQR: 20.4-37.5).

CONCLUSION

Our study suggests, in the largest cohort to date, that MMF may be an effective alternative to thiopurines and methotrexate in IBD.

摘要

背景

在生物治疗出现后，评估霉酚酸酯（MMF）在炎症性肠病（IBD）中应用的研究有限。

目的

我们的主要目标是评估MMF在IBD中的有效性和安全性。

方法

从ENEIDA登记处检索接受MMF治疗的IBD患者。在基线、3个月、6个月和最终随访时，根据哈维 - 布拉德肖指数（HBI）、部分梅奥评分（pMS）、医生整体评估（PGA）和C反应蛋白（CRP）评估临床活动情况。记录不良事件和治疗中断原因。

结果

共纳入83例患者（66例克罗恩病，17例溃疡性结肠炎），其中90%此前接受过其他免疫抑制剂治疗。61%的患者在开始使用MMF时使用了全身性激素，27.3%的患者将生物制剂与MMF联合使用。总体64.7%的患者观察到临床有效性。治疗结束时，分别有45.6%和19.1%的受试者达到缓解和临床反应。MMF治疗的中位持续时间为28.9个月（四分位间距：20.4 - 37.5）。