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炎症性肠病药物的风险与获益:一项医生与患者调查

Risk-Benefit of IBD Drugs: A Physicians and Patients Survey.

作者信息

D'Amico Ferdinando, Vieujean Sophie, Caron Benedicte, Peyrin-Biroulet Laurent, Danese Silvio

机构信息

Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy.

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy.

出版信息

J Clin Med. 2023 Apr 24;12(9):3094. doi: 10.3390/jcm12093094.

Abstract

BACKGROUND

Treatment choices for patients with inflammatory bowel disease (IBD) are based on the balance between risks and benefits. Our AI was to compare the perspectives of patients and physicians in evaluating the risks and benefits before initiating therapy for IBD.

METHODS

An anonymous survey was conducted between March and August 2022. All patients with confirmed IBD and all physicians who attended an IBDscope webinar were invited to participate.

RESULTS

In total, 367 patients and 146 physicians participated. For most patients (71.4%) and physicians (89.0%), efficacy and safety were equally important. Clinical improvement and clinical remission were the most relevant outcomes for patients (90.9 and 88.4), while clinical remission and endoscopic remission were for physicians (90.0 and 87.6). The main factors in the benefit-risk assessment were quality of life (95.1%), disease activity (87.5%), and presence of comorbidities (84.5%) for patients, and presence of comorbidities (99.3%), disease activity (97.9%), and prior failure to biologics/small molecules (96.6%) for physicians. Based on patients' and physicians' opinions, the risk of serious infections, malignancies, cardiovascular events, death, relapse, all infections, surgery, and hospitalization should be included in the benefit-risk assessment.

CONCLUSION

Physicians and patients have different priorities in evaluating the benefit-risk balance of a new therapy.

摘要

背景

炎症性肠病(IBD)患者的治疗选择基于风险与获益之间的平衡。我们的人工智能旨在比较患者和医生在启动IBD治疗前评估风险和获益方面的观点。

方法

2022年3月至8月进行了一项匿名调查。邀请了所有确诊为IBD的患者以及所有参加IBDscope网络研讨会的医生参与。

结果

共有367名患者和146名医生参与。对于大多数患者(71.4%)和医生(89.0%)而言,疗效和安全性同样重要。临床改善和临床缓解是患者最关注的结果(分别为90.9%和88.4%),而临床缓解和内镜缓解则是医生最关注的(分别为90.0%和87.6%)。患者进行获益-风险评估的主要因素是生活质量(95.1%)、疾病活动度(87.5%)和合并症的存在(84.5%),医生进行获益-风险评估的主要因素是合并症的存在(99.3%)、疾病活动度(97.9%)和既往生物制剂/小分子药物治疗失败(96.6%)。基于患者和医生的意见,严重感染、恶性肿瘤、心血管事件、死亡、复发、所有感染、手术和住院的风险应纳入获益-风险评估。

结论

医生和患者在评估新疗法的获益-风险平衡时具有不同的优先考量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7204/10179123/1f20007e1d2c/jcm-12-03094-g001.jpg

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