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前瞻性队列研究中采用主动治疗药物监测在接受抗肿瘤坏死因子治疗的炎症性肠病儿童中的优势。

Advantages of Proactive Therapeutic Drug Monitoring in a Prospective Cohort of Children With Inflammatory Bowel Disease Treated With Anti-Tumour Necrosis Factor.

机构信息

Department of Paediatric Gastroenterology, The Royal London Children's Hospital, Barts Health NHS Trust.

Blizard Institute, Barts and the London, Queen Mary University London, London, UK.

出版信息

J Pediatr Gastroenterol Nutr. 2022 Apr 1;74(4):484-489. doi: 10.1097/MPG.0000000000003389. Epub 2022 Feb 3.

Abstract

Few studies have addressed whether proactive therapeutic drug monitoring (TDM) results in improved clinical outcomes in children with inflammatory bowel disease (IBD) treated with anti-tumour necrosis factor. The aim of this study was to investigate the impact of using proactive TDM in this patient group.Pilot single-centre observational study to accrue data on patients managed with proactive TDM.More patients in the proactive TDM cohort were managed by escalating the infliximab (IFX) regime (P < 0.001). The need for switching to different biologics was significantly lower in this patient group (P < 0.001).The introduction of proactive TDM resulted in a significant reduction of patients requiring switch of their primary biologic. The results of this study are indicators that proactive TDM offers a better method of managing children with IBD on IFX therapy.

摘要

很少有研究探讨在接受肿瘤坏死因子拮抗剂治疗的炎症性肠病(IBD)儿童中,积极的治疗药物监测(TDM)是否会改善临床结局。本研究旨在调查在该患者群体中使用积极 TDM 的影响。

这是一项单中心前瞻性观察研究,旨在积累接受积极 TDM 管理的患者数据。

积极 TDM 组中有更多的患者接受了英夫利昔单抗(IFX)方案的升级(P < 0.001)。该患者组中转用其他生物制剂的需求显著降低(P < 0.001)。

采用积极 TDM 后,显著降低了需要转换主要生物制剂的患者人数。本研究的结果表明,积极 TDM 为接受 IFX 治疗的 IBD 患儿提供了一种更好的管理方法。

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