在 IBD 中适时引入、优化和维持抗 TNF 治疗：来自 Delphi 共识的结果。
Timing of proper introduction, optimization and maintenance of anti-TNF therapy in IBD: Results from a Delphi consensus.
机构信息
Gastrointestinal Unit ASST Fatebenefratelli Sacco-University of Milan, Milan, Italy.
IBD Center, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy.
出版信息
Dig Liver Dis. 2024 Jan;56(1):98-105. doi: 10.1016/j.dld.2023.09.003. Epub 2023 Sep 21.
BACKGROUND
Crohn's disease and ulcerative colitis are inflammatory bowel diseases (IBDs) with a rapidly growing worldwide incidence. The last decades presented rapid progress in pharmacological treatment leading in many cases to clinical and endoscopic remission, including biological treatment with anti-TNF agents.
AIM
The exact timing of introduction, optimization and maintenance of anti-TNF therapy in IBDs is not thoroughly covered in current guidelines.
METHODS
We used the Delphi panel methodology to gather the IBD experts' views and achieve consensus for clinical recommendations on introducing and maintaining anti-TNF therapy for patients with IBDs.
RESULTS
Twelve recommendations achieved a high level of consensus in two assessment rounds by 52 (1st round) and 47 (2nd round) IBD experts.
CONCLUSION
In many clinical situations, the early use of anti-TNF therapy is recommended. Nowadays, the cost-efficacy profile of anti-TNF biosimilars makes them the first-line drug in a substantial proportion of patients, thus providing the opportunity to increase access to biological therapy.
背景
克罗恩病和溃疡性结肠炎是炎症性肠病（IBD），其全球发病率正在迅速增长。过去几十年中，在药理学治疗方面取得了快速进展，导致许多患者达到临床和内镜缓解，包括使用抗 TNF 药物的生物治疗。
目的
目前的指南并未详细涵盖 IBD 中抗 TNF 治疗的引入、优化和维持的确切时机。
方法
我们使用 Delphi 小组方法收集 IBD 专家的意见，并就 IBD 患者引入和维持抗 TNF 治疗的临床建议达成共识。
结果
在两轮评估中，有 12 项建议得到了 52 位（第一轮）和 47 位（第二轮）IBD 专家的高度共识。
结论
在许多临床情况下，建议早期使用抗 TNF 治疗。如今，抗 TNF 生物类似物的成本效益情况使其成为大部分患者的一线药物，从而为增加生物治疗的可及性提供了机会。
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