Caron Bénédicte, D'Amico Ferdinando, Jairath Vipul, Netter Patrick, Danese Silvio, Peyrin-Biroulet Laurent
Department of Gastroenterology and Inserm NGERE U1256, Nancy University Hospital, University of Lorraine, Vandoeuvre-lès-Nancy, France.
Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele Milano, Milan, Italy.
J Crohns Colitis. 2023 Jan 27;17(1):137-143. doi: 10.1093/ecco-jcc/jjac113.
Medical treatment for inflammatory bowel disease has advanced significantly over the two past decades. The advent of biologics and small molecules has revolutionised outcomes for patients with inflammatory bowel disease. Knowledge of drug pharmacology, indications, and adverse events is essential to ensure the best clinical care while minimising toxicity. Our aim was to review the literature on current methods of benefit-risk assessment, and consider their practical applicability to inflammatory bowel disease.
A literature search was conducted to investigate studies documenting benefit-risk assessment.
Several structured frameworks and quantitative methodologies have been developed to evaluate benefit-risk profiles of drugs in a more comprehensive and consistent framework. Quantitative methods integrate benefit and risk outcome measures or incorporate preference weights for benefit and risk criteria into the evaluation. Incorporation of preference weights from patients is an essential aspect of quantitative benefit-risk assessment. Benefit-risk assessment is still evolving in inflammatory bowel disease.
The risks and benefits of each medical therapy must be discussed with the patient and a shared decision-making process is recommended. Future initiatives should be developed to perform a benefit-risk assessment considering the characteristics of inflammatory bowel disease drugs.
在过去二十年中,炎症性肠病的医学治疗取得了显著进展。生物制剂和小分子药物的出现彻底改变了炎症性肠病患者的治疗结局。了解药物药理学、适应证和不良事件对于确保最佳临床护理并将毒性降至最低至关重要。我们的目的是回顾关于当前获益-风险评估方法的文献,并考虑其在炎症性肠病中的实际适用性。
进行文献检索以调查记录获益-风险评估的研究。
已经开发了几种结构化框架和定量方法,以在更全面和一致的框架中评估药物的获益-风险概况。定量方法整合了获益和风险结果测量,或将获益和风险标准的偏好权重纳入评估。纳入患者的偏好权重是定量获益-风险评估的一个重要方面。炎症性肠病的获益-风险评估仍在不断发展。
必须与患者讨论每种医学治疗的风险和获益,并建议采用共同决策过程。未来应开展相关举措,考虑炎症性肠病药物的特点进行获益-风险评估。