纤维及红肉/加工肉类摄入量对开始生物治疗的慢性炎症性疾病患者治疗结局的影响：一项前瞻性队列研究。
Impact of fibre and red/processed meat intake on treatment outcomes among patients with chronic inflammatory diseases initiating biological therapy: A prospective cohort study.
作者信息
Overgaard Silja H, Sørensen Signe B, Munk Heidi L, Nexøe Anders B, Glerup Henning, Henriksen Rikke H, Guldmann Tanja, Pedersen Natalia, Saboori Sanaz, Hvid Lone, Dahlerup Jens F, Hvas Christian L, Jawhara Mohamad, Andersen Karina W, Pedersen Andreas K, Nielsen Ole H, Bergenheim Fredrik, Brodersen Jacob B, Heitmann Berit L, Halldorsson Thorhallur I, Holmskov Uffe, Bygum Anette, Christensen Robin, Kjeldsen Jens, Ellingsen Torkell, Andersen Vibeke
机构信息
The Molecular Diagnostics and Clinical Research Unit, Departement of Blood Samples, Biochemistry and Immunology, University Hospital of Southern Denmark, Aabenraa, Denmark.
Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
出版信息
Front Nutr. 2022 Oct 13;9:985732. doi: 10.3389/fnut.2022.985732. eCollection 2022.
BACKGROUND
Biologic disease-modifying drugs have revolutionised the treatment of a number of chronic inflammatory diseases (CID). However, up to 60% of the patients do not have a sufficient response to treatment and there is a need for optimization of treatment strategies.
OBJECTIVE
To investigate if the treatment outcome of biological therapy is associated with the habitual dietary intake of fibre and red/processed meat in patients with a CID.
METHODS
In this multicentre prospective cohort study, we consecutively enrolled 233 adult patients with a diagnosis of Crohn's Disease, Ulcerative Colitis, Rheumatoid Arthritis (RA), Axial Spondyloarthritis, Psoriatic Arthritis and Psoriasis, for whom biologic therapy was planned, over a 3 year period. Patients with completed baseline food frequency questionnaires were stratified into a high fibre/low red and processed meat exposed group (HFLM) and an unexposed group (low fibre/high red and processed meat intake = LFHM). The primary outcome was the proportion of patients with a clinical response to biologic therapy after 14-16 weeks of treatment.
RESULTS
Of the 193 patients included in our primary analysis, 114 (59%) had a clinical response to biologic therapy. In the HFLM group ( = 64), 41 (64%) patients responded to treatment compared to 73 (56%) in the LFHM group ( = 129), but the difference was not statistically significant (OR: 1.48, 0.72-3.05). For RA patients however, HFLM diet was associated with a more likely clinical response (82% vs. 35%; OR: 9.84, 1.35-71.56).
CONCLUSION
Habitual HFLM intake did not affect the clinical response to biological treatment across CIDs. HFLM diet in RA patients might be associated with better odds for responding to biological treatment, but this would need confirmation in a randomised trial.
TRIAL REGISTRATION
(clinicaltrials.gov), identifier [NCT03173144].
背景
生物疾病改善药物彻底改变了多种慢性炎症性疾病（CID）的治疗方式。然而，高达60%的患者对治疗反应不足，因此需要优化治疗策略。
目的
研究在CID患者中，生物治疗的疗效是否与膳食纤维和红肉/加工肉的习惯性饮食摄入量有关。
方法
在这项多中心前瞻性队列研究中，我们在3年时间里连续招募了233名计划接受生物治疗的成年患者，他们被诊断为克罗恩病、溃疡性结肠炎、类风湿关节炎（RA）、轴性脊柱关节炎、银屑病关节炎和银屑病。完成基线食物频率问卷的患者被分为高纤维/低红肉和加工肉暴露组（HFLM）和未暴露组（低纤维/高红肉和加工肉摄入量 = LFHM）。主要结局是治疗14 - 16周后对生物治疗有临床反应的患者比例。
结果
在纳入我们主要分析的193名患者中，114名（59%）对生物治疗有临床反应。在HFLM组（n = 64）中，41名（64%）患者对治疗有反应，而LFHM组（n = 129）中有73名（56%）患者有反应，但差异无统计学意义（OR：1.48，0.72 - 3.05）。然而，对于RA患者，HFLM饮食与更可能的临床反应相关（82%对35%；OR：9.84，1.35 - 71.56）。
结论
习惯性HFLM摄入量并未影响CID患者对生物治疗的临床反应。RA患者的HFLM饮食可能与对生物治疗有更好反应的几率相关，但这需要在随机试验中得到证实。
试验注册
（clinicaltrials.gov），标识符[NCT03173144]
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