Cai Chenwen, Lu Juntao, Lai Lijie, Song Dongjuan, Shen Jun, Tong Jinlu, Zheng Qing, Wu Kaichun, Qian Jiaming, Ran Zhihua
Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China.
Department of Gastroenterology, Xijing Hospital, Air Force Medical University, Xi'an, China.
Intest Res. 2022 Apr;20(2):213-223. doi: 10.5217/ir.2021.00031. Epub 2022 Apr 29.
BACKGROUND/AIMS: The incidence and prevalence of inflammatory bowel disease (IBD) is rising in Asia recently. The study aimed to obtain a comprehensive understanding of the current status of drug therapy and monitoring for IBD in Asia.
A questionnaire investigation on drug therapy and monitoring for IBD was conducted right before the 6th Annual Meeting of Asian Organization for Crohn's & Colitis. Questionnaires were provided to Asian physicians to fill out via emails between March and May 2018.
In total, responses of 166 physicians from 129 medical centers were included for analysis. Among the surveyed regions, the most average number of IBD specialist gastroenterologists and nurses was 4.8 per center in Taiwan and 2.5 per center in Mainland China, respectively. 5-Aminosalicylic acid/sulfasalazine (99.4%) was the most preferred first-line choice for mild-moderate ulcerative colitis (UC), meanwhile corticosteroid (83.7%) was widely applied for severe UC. The first-line medication for Crohn's disease (CD) markedly varied as corticosteroid (68.1%) was the most favored in Mainland China, Japan, and South Korea, followed by infliximab (52.4%) and azathioprine (47.0%). Step-up strategy was preferred in mild-moderate UC (96.4%), while 51.8% of the physicians selected top-down treatment for CD. Only 25.9% and 17.5% of the physicians could test blood concentration of infliximab and antibody to infliximab in their hospitals, respectively.
The current status of drug therapy and monitoring for IBD in Asia possesses commonalities as well as differences. Asian recommendations, IBD specialist teams and practice of therapeutic drug monitoring are required to improve IBD management in Asia.
背景/目的：近年来，亚洲炎症性肠病（IBD）的发病率和患病率呈上升趋势。本研究旨在全面了解亚洲IBD药物治疗和监测的现状。
在亚洲克罗恩病和结肠炎组织第六届年会上，对IBD药物治疗和监测进行了问卷调查。2018年3月至5月期间，通过电子邮件向亚洲医生提供问卷进行填写。
共纳入来自129个医疗中心的166名医生的回复进行分析。在调查的地区中，台湾地区每个中心IBD专科胃肠病学家和护士的平均人数最多，分别为4.8人，中国大陆为每个中心2.5人。5-氨基水杨酸/柳氮磺胺吡啶（99.4%）是轻度至中度溃疡性结肠炎（UC）最常用的一线治疗药物，同时皮质类固醇（83.7%）广泛应用于重度UC。克罗恩病（CD）的一线用药差异显著，中国大陆、日本和韩国最常用的是皮质类固醇（68.1%），其次是英夫利昔单抗（52.4%）和硫唑嘌呤（47.0%）。轻度至中度UC首选逐步升级策略（96.4%），而51.8%的医生选择对CD进行自上而下的治疗。分别只有25.9%和17.5%的医生能够在其医院检测英夫利昔单抗的血药浓度和抗英夫利昔单抗抗体。
亚洲IBD药物治疗和监测的现状既有共性也有差异。需要亚洲地区的建议、IBD专科团队和治疗药物监测实践来改善亚洲的IBD管理。
