Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK.
Ingress-Health HWM GmbH, Wismar, Germany.
Curr Med Res Opin. 2023 May;39(5):681-689. doi: 10.1080/03007995.2023.2194782. Epub 2023 Apr 18.
A considerable proportion of patients with moderate-to-severe ulcerative colitis (UC) treated with advanced therapies do not achieve remission, even after 1 year of treatment, and suboptimal response to advanced therapies is frequently observed in clinical practice. This study aimed to analyze clinical practice data in the United Kingdom (UK) and assess the rates of clinical remission and inadequate response with advanced therapies among patients with UC.
This retrospective chart review included patients with UC who initiated a new advanced therapy (i.e. adalimumab, infliximab, golimumab, tofacitinib, or vedolizumab) between January 2017 and September 2019 from eight clinics across the UK. At least 12 months of data before and after starting an advanced therapy were required. Remission was assessed using components of the Mayo score. Inadequate response was defined by therapeutic adjustment or emergency treatment.
Among 238 patients included (female: 46.6%; median age: 42.0 years; median follow-up: 28.8 months), 178 patients (74.8%) were biologic-naïve. At 12 months, 87 patients (53.9%) had achieved remission (median time to remission: 7.6 months), although 29 (33.3%) among them had required therapeutic modifications to achieve remission. At 12 months, 105 patients (44.3%) had at least one indicator of an inadequate response (median time to the first indicator of inadequate response: 18.0 months).
Nearly half of the patients did not achieve remission, and almost half of the included patients had an inadequate response within 1 year after treatment initiation. More effective therapies are needed to effectively treat UC.
相当一部分接受高级治疗的中重度溃疡性结肠炎 (UC) 患者即使在治疗 1 年后仍未缓解，且在临床实践中经常观察到高级治疗的反应不佳。本研究旨在分析英国 (UK) 的临床实践数据，并评估 UC 患者接受高级治疗后达到临床缓解和反应不佳的比例。
本回顾性图表研究纳入了 2017 年 1 月至 2019 年 9 月期间在英国八家诊所开始新的高级治疗（即阿达木单抗、英夫利昔单抗、戈利木单抗、托法替布或维得利珠单抗）的 UC 患者。在开始高级治疗之前和之后至少需要 12 个月的数据。缓解使用 Mayo 评分的组成部分进行评估。反应不佳定义为治疗调整或紧急治疗。
共纳入 238 例患者（女性：46.6%；中位年龄：42.0 岁；中位随访：28.8 个月），178 例（74.8%）为生物初治患者。在 12 个月时，87 例（53.9%）患者达到缓解（缓解的中位时间：7.6 个月），但其中 29 例（33.3%）需要治疗调整才能达到缓解。在 12 个月时，105 例（44.3%）至少有一个反应不佳的指标（第一次反应不佳指标的中位时间：18.0 个月）。
近一半的患者未达到缓解，近一半的患者在治疗开始后 1 年内出现反应不佳。需要更有效的治疗方法来有效治疗 UC。
