Livne-Margolin Moran, Ling Daniel, Attia-Konyo Shani, Abitbol Chaya Mushka, Haj-Natour Ola, Ungar Bella, Ben-Horin Shomron, Kopylov Uri
Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Dig Liver Dis. 2023 Feb;55(2):223-229. doi: 10.1016/j.dld.2022.09.009. Epub 2022 Oct 11.
Extraintestinal manifestations (EIM) are associated with diminished quality of life. The efficacy of Ustekinumab and vedolizumab for EIM treatment is not well established. The aim was to compare the effectiveness of ustekinumab and vedolizumab for treatment of EIM in IBD.
We included IBD patients treated with vedolizumab or ustekinumab in the Gastroenterology department, Sheba Medical Center, for up to 52 weeks between 2015 and 2021. Patients with active EIM before treatment initiation were included.
111 patients were included. 53 patients (48%) were treated with ustekinumab; 88% (n-99) had CD. The most common EIM was arthralgia (95/111, 84%). Patients treated with ustekinumab were more likely to be anti-TNF experienced (n-51/53 [96%] compared with vedolizumab n = 36/58 [62%], p < 0.001). Clinical response of EIM at week 52 was achieved in 36% of patients treated with ustekinumab (n-18/50) and 34% of patients (n-19/54) treated with vedolizumab, with no statistically significant difference (p = 0.9). No statistical significance was achieved for patients presented with arthralgia. Clinical response of arthralgia at week 52 was seen in 34% (n-19/55) and 36% (n-18/46) of the patients treated with vedolizumab and ustekinumab, respectively, (p = 0.3).
In this study, no difference was found between vedolizumab and ustekinumab regarding their effect on EIM in IBD patients for up to 52 weeks.
肠外表现(EIM)与生活质量下降相关。乌司奴单抗和维多珠单抗治疗EIM的疗效尚未明确。本研究旨在比较乌司奴单抗和维多珠单抗治疗炎症性肠病(IBD)患者EIM的有效性。
纳入2015年至2021年期间在舍巴医疗中心胃肠病科接受维多珠单抗或乌司奴单抗治疗长达52周的IBD患者。纳入治疗开始前有活动性EIM的患者。
共纳入111例患者。53例患者(48%)接受乌司奴单抗治疗;88%(n = 99)患有克罗恩病(CD)。最常见的EIM是关节痛(95/111,84%)。接受乌司奴单抗治疗的患者更有可能曾接受过抗肿瘤坏死因子(TNF)治疗(n = 51/53 [96%],而维多珠单抗组为n = 36/58 [62%],p < 0.001)。接受乌司奴单抗治疗的患者中,36%(n = 18/50)在第52周时EIM获得临床缓解,接受维多珠单抗治疗的患者中这一比例为34%(n = 19/54),差异无统计学意义(p = 0.9)。关节痛患者未达到统计学显著性差异。接受维多珠单抗和乌司奴单抗治疗的患者中,分别有34%(n = 19/55)和36%(n = 18/46)在第52周时关节痛获得临床缓解(p = 0.3)。
在本研究中,长达52周的观察期内,维多珠单抗和乌司奴单抗对IBD患者EIM的治疗效果无差异。