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巴西成人溃疡性结肠炎管理第二次共识:巴西克罗恩病和结肠炎组织(GEDIIB)的共识。

SECOND BRAZILIAN CONSENSUS ON THE MANAGEMENT OF ULCERATIVE COLITIS IN ADULTS: A CONSENSUS OF THE BRAZILIAN ORGANIZATION FOR CROHN'S DISEASE AND COLITIS (GEDIIB).

机构信息

Universidade Nove de Julho, Bauru, SP, Brasil.

Hospital das Clínicas da Faculdade de Medicina de Botucatu, Botucatu, SP, Brasil.

出版信息

Arq Gastroenterol. 2023 Mar 24;59(suppl 1):51-84. doi: 10.1590/S0004-2803.2022005S1-03. eCollection 2023.

DOI:10.1590/S0004-2803.2022005S1-03
PMID:
36995889
Abstract

BACKGROUND

Inflammatory bowel diseases are immune-mediated disorders that include Crohn's disease (CD) and ulcerative colitis (UC). UC is a progressive disease that affects the colorectal mucosa causing debilitating symptoms leading to high morbidity and work disability. As a consequence of chronic colonic inflammation, UC is also associated with an increased risk of colorectal cancer.

OBJECTIVE

This consensus aims to provide guidance on the most effective medical management of adult patients with UC.

METHODS

A consensus statement was developed by stakeholders representing Brazilian gastroenterologists and colorectal surgeons (Brazilian Organization for Crohn's Disease and Colitis [GEDIIB]). A systematic review including the most recent evidence was conducted to support the recommendations and statements. All recommendations/statements were endorsed using a modified Delphi Panel by the stakeholders/experts in inflammatory bowel disease with at least 80% or greater consensus.

RESULTS AND CONCLUSION

The medical recommendations (pharmacological and non-pharmacological) were mapped according to the stage of treatment and severity of the disease onto three domains: management and treatment (drug and surgical interventions), criteria for evaluating the effectiveness of medical treatment, and follow-up/patient monitoring after initial treatment. The consensus targeted general practitioners, gastroenterologists and surgeons who manage patients with UC, and supports decision-making processes by health insurance companies, regulatory agencies, health institutional leaders, and administrators.

摘要

背景

炎症性肠病是一种免疫介导的疾病,包括克罗恩病(CD)和溃疡性结肠炎(UC)。UC 是一种进行性疾病,影响结直肠黏膜,导致使人衰弱的症状,导致高发病率和工作能力丧失。由于慢性结肠炎症,UC 还与结直肠癌的风险增加相关。

目的

本共识旨在为成人 UC 患者的最有效医学管理提供指导。

方法

由代表巴西胃肠病学家和结直肠外科医生的利益相关者(巴西克罗恩病和结肠炎组织[GEDIIB])制定了一项共识声明。进行了系统评价,纳入了最新的证据,以支持建议和声明。所有建议/声明均由炎症性肠病的利益相关者/专家使用改良 Delphi 小组进行背书,至少 80%或以上的专家达成共识。

结果和结论

根据治疗阶段和疾病严重程度,将医学建议(药物和非药物)映射到三个领域:管理和治疗(药物和手术干预)、评估药物治疗效果的标准,以及初始治疗后的随访/患者监测。该共识针对的是管理 UC 患者的普通科医生、胃肠病学家和外科医生,并为保险公司、监管机构、卫生机构领导人和管理人员的决策过程提供支持。

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