摘要
目的评估生物制剂双靶治疗难治克罗恩病(CD)的短期疗效。方法回顾性分析2020年1月26日至2021年8月15日解放军总医院第七医学中心5例生物制剂双靶治疗难治性CD的临床特征及诊治过程。通过检索MEDLINE、EMBASE和Cochrane Library中截止至2021年8月发表的生物制剂双靶治疗文章,并进行相关文献复习及总结。结果纳入5例难治性CD患者,均为男性,年龄40.8(23.0,56.0)岁,病程10.4(6.0,17.0)年,其中2例英夫利西单抗(IFX)联合乌司奴单抗(UST),2例IFX联合维得利珠单抗(VDZ),1例UST联合VDZ治疗。含VDZ组联合治疗后第14周,不含VDZ组联合治疗后第16周进行实验室及结肠镜复查。本组5例经联合治疗14~16周后复查,结果显示1例临床缓解,3例临床应答,3例内镜应答。联合UST组均表现出较好的疗效。5例患者联合治疗后随访半年均未出现特殊药物不良反应。共检索到17篇相关报道。结论生物制剂双靶治疗可能是一种对难治性CD短期有效、安全性较好的治疗方案。
Objective To evaluate the short-term efficacy of dual biologics combination therapy in the treatment of refractory Crohn's disease(CD).Methods The clinical features,diagnosis and treatment of 5 cases of refractory CD treated with biologics dual-target therapy in the Seventh Medical Center of Chinese PLA General Hospital between January 26,2020 and August 15,2021 were retrospectively analyzed.The relevant literatures were reviewed and summarized by searching the articles on biologics dual-target therapy published in MEDLINE,EMBASE and Cochrane Library until August 2021.Results Five patients with refractory CD were all male,aged 40.8(23.0,56.0)years,with disease course of 10.4(6.0,17.0)years,including 2 patients treated with infliximab(IFX)in combination with ustekinumab(UST).Two patients treated with IFX in combination with vedolizumab(VDZ)and 1 patient treated with UST in combination with VDZ.Laboratory and colonoscopy examinations were performed 14 weeks after combination therapy in the VDZ containing group and 16 weeks after combination therapy in the VDZ free group.Results of examinations after treatment indicated that 1 case presented clinical remission,3 cases presented clinical response and 3 cases presented endoscopic response.Combination therapy group with UST had better efficacy.None of the 5 patients had special adverse drug reactions during follow-up for six months after combined treatment.A total of 17 relevant reports were retrieved.Conclusion Biologic dual-target therapy may be a short-term effective and safe treatment for refractory CD.
作者
贾燕
朱少康
马贤纵
张丽敏
杜树文
范鑫
李世荣
金鹏
Jia Yan;Zhu Shaokang;Ma Xianzong;Zhang Limin;Du Shuwen;Fan Xin;Li Shirong;Jin Peng(Department of Gastroenterology,the Seventh Medical Center of Chinese PLA General Hospital,Beijing 100700,China;School of Basic Medicine,Air Force Medical University,Xi'an 710032,China;Chinese PLA Medical School,Beijing 100853,China;Senior Department of Gastroenterology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)
出处
《中华炎性肠病杂志（中英文）》
2022年第3期228-234,共7页
Chinese Journal of Inflammatory Bowel Diseases
基金
首都卫生发展科研专项(2018-1-5091)。
