Khoshnam-Rad Niloofar, Vahedi Homayoon, Sadeghi Anahita, Rastegarpanah Mansoor, Namazi Soha, Anushiravani Amir, Sima Ali Reza, Shahrokh Shabnam, Alatab Sudabeh, Malekzadeh Reza
Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Middle East J Dig Dis. 2023 Apr;15(2):83-106. doi: 10.34172/mejdd.2023.327. Epub 2023 Apr 30.
Pharmacotherapy with biologics and small molecules, as the more effective therapies for moderate to severe ulcerative colitis (UC) and Crohn's disease (CD), is complex. Choosing the best methods for their utilization in order to induce and maintain remission are critical for practicing gastroenterologists. We aimed to develop an Iranian consensus on the management of inflammatory bowel disease (IBD) patients with biologics and small molecules. A Delphi consensus was undertaken by experts who performed a literature summary and voting process. Quality of evidence was assessed using the Grading and Recommendations Assessment, Development, and Evaluation; and an additional risk of bias-protocol. Following an extensive search of the literature, 219 studies were used to determine the quality of the evidence. After three rounds of voting, consensus (defined as≥80% agreement) was reached for 87 statements. We considered different aspects of pharmacotherapy in this consensus. This guideline, along with clinical judgment, can be used to optimize management of IBD patients.
生物制剂和小分子药物作为治疗中度至重度溃疡性结肠炎(UC)和克罗恩病(CD)更有效的疗法,其药物治疗较为复杂。选择最佳的使用方法以诱导和维持缓解,对胃肠病学医生的临床实践至关重要。我们旨在就使用生物制剂和小分子药物治疗炎症性肠病(IBD)患者达成伊朗国内共识。由专家进行德尔菲共识法,包括文献总结和投票过程。使用分级和推荐评估、发展与评价系统(GRADE)以及额外的偏倚风险方案来评估证据质量。在广泛检索文献后,共219项研究被用于确定证据质量。经过三轮投票,就87项声明达成了共识(定义为≥80%的一致意见)。我们在该共识中考虑了药物治疗的不同方面。本指南结合临床判断,可用于优化IBD患者的管理。