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异体扩增脂肪间充质干细胞治疗肛周瘘管性难治性克罗恩病的真实疗效。

Real-life effectiveness of allogeneic expanded adipose-derived mesenchymal stem cell therapy for perianal fistulizing refractory Crohn's disease.

机构信息

Department of Gastroenterology, Lyon Sud Hospital, Hospices Civils de Lyon, University Claude Bernard Lyon 1, France.

Department of Digestive Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, University Claude Bernard Lyon 1, France.

出版信息

Clin Res Hepatol Gastroenterol. 2024 Nov;48(9):102473. doi: 10.1016/j.clinre.2024.102473. Epub 2024 Sep 28.

Abstract

BACKGROUND

Real life data about the long-term efficacy of darvadstrocel for treating perianal fistulas in Crohn's disease (CD) remain scarce.

AIM

To report the effectiveness and safety of darvadstrocel therapy to close perianal fistula in a real-life cohort of CD patients.

METHODS

All patients with CD suffering complex draining perianal fistulas who consecutively underwent administration of a single local injection of darvadstrocel at two centres were followed up and evaluated. The primary endpoint was clinical remission (closure of all external openings with no discharge at pressure) at week 24. Combined remission (defined as clinically plus MRI-assessed fistula closure) were also assessed at week 24 and 52.

RESULTS

A total of 36 CD patients (19 Male, mean age 38.5 years) were included with a median follow up of 16 months. Clinical remission was achieved in 17 out of 36 patients (47.2 %) and combined remission in 15 out of 36 patients (41.6 %) at week 24. At week 52, clinical and combined remission was achieved in 17 out of 36 patients (47.2 %) and in 15 out of 33 evaluable patients (45.4 %), respectively.

CONCLUSION

In this real-world setting, a successful response to darvadstrocel therapy based on clinical remission was reported in around half of the patients and combined remission including radiological assessment in more than 4 out of 10 patients.

摘要

背景

关于达伐司他丁治疗克罗恩病(CD)肛周瘘的长期疗效的真实数据仍然很少。

目的

报告达伐司他丁治疗 CD 患者肛周瘘的有效性和安全性。

方法

在两个中心,对连续接受单次局部注射达伐司他丁的 CD 患者进行随访和评估。主要终点是在 24 周时临床缓解(所有外部开口闭合,无压力下渗出)。在 24 周和 52 周时还评估了联合缓解(定义为临床和 MRI 评估的瘘管闭合)。

结果

共纳入 36 例 CD 患者(19 例男性,平均年龄 38.5 岁),中位随访时间为 16 个月。在 24 周时,17/36 例(47.2%)患者达到临床缓解,15/36 例(41.6%)患者达到联合缓解。在 52 周时,17/36 例(47.2%)和 15/33 例可评估患者(45.4%)达到临床和联合缓解。

结论

在这个真实环境中,约一半的患者基于临床缓解的达伐司他丁治疗反应成功,超过 10 例患者中的 4 例以上达到联合缓解,包括放射学评估。

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