Department of Gastroenterology, CHU Saint-Etienne, Clinique Mutualiste, Saint Etienne, France.
Department of Gastroenterology and Hepatology, Centre Médico-chirurgical Magellan Hôpital Haut-Lévêque, CHU de Bordeaux, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France.
Clin Gastroenterol Hepatol. 2023 May;21(5):1354-1355.e2. doi: 10.1016/j.cgh.2022.03.008. Epub 2022 Mar 17.
Ulcerative colitis is a chronic inflammatory bowel disease. Approximately 20% of patients experience an acute severe attack during their life. In acute severe ulcerative colitis (ASUC), first-line therapy is intravenous (IV) steroids. In the absence of clinical improvement, 2 medical options can be considered: ciclosporin or infliximab. In ASUC, ciclosporin is commonly used as a bridging therapy for thiopurines. Pellet et al found that the same bridge strategy with vedolizumab was effective and can avoid colectomy. Given that an increasing number of patients with ASUC have been exposed to thiopurines, vedolizumab, and anti-tumor necrosis factor biologic therapies, newer approaches are needed in these patients, such as tofacitinib or ustekinumab. Ustekinumab, an antagonist of the p40 subunit of interleukin-12 and interleukin-23, has shown efficacy in ulcerative colitis and can be given in this indication. In this retrospective study, we evaluate the efficacy and safety of a bridge from calcineurin inhibitor to ustekinumab in patients with ASUC.
溃疡性结肠炎是一种慢性炎症性肠病。大约 20%的患者在其一生中会经历急性重度发作。在急性重度溃疡性结肠炎（ASUC）中，一线治疗是静脉注射（IV）类固醇。如果临床没有改善，可以考虑 2 种医学选择：环孢素或英夫利昔单抗。在 ASUC 中，环孢素通常用作硫嘌呤的桥接治疗。Pellet 等人发现，使用维得利珠单抗的相同桥接策略是有效的，可以避免结肠切除术。鉴于越来越多的 ASUC 患者已经接触过硫嘌呤、维得利珠单抗和抗肿瘤坏死因子生物疗法，这些患者需要新的方法，例如托法替尼或乌司奴单抗。乌司奴单抗是白细胞介素-12 和白细胞介素-23 的 p40 亚单位拮抗剂，已显示出在溃疡性结肠炎中的疗效，并可用于该适应证。在这项回顾性研究中，我们评估了在 ASUC 患者中从钙调神经磷酸酶抑制剂桥接到乌司奴单抗的疗效和安全性。
