中国临床药学杂志2024，Vol.33Issue(8)：598-604,7.DOI:10.19577/j.1007-4406.2024.08.008
肿瘤坏死因子α拮抗剂和维得利珠单抗治疗炎症性肠病的持久性及影响因素
Long-term treatment persistence and influencing factors of tumor necrosis factor α antagonists and vedolizumab in patients with inflammatory bowel diseases
摘要
Abstract
AIM To assess the durability of treatment and risk factors for treatment failure in the patients with inflammatory bowel diseases(IBD)receiving tumor necrosis factor α antagonist(anti-TNF)or vedolizumab(VDZ)therapy.METHODS Single-centre,retrospective study from a register including patients who received anti-TNF or VDZ therapy in the last 8 years at the study centre.The Kaplan-Meier method was used to calculate the treatment persistence,and the log-rank method was used for comparison.With multivariable Cox regression analysis,risk factors for treatment failure were investigated.RESULTS Among the 210 patients included,168 received anti-TNF and 42 received VDZ.Median(95％confidence interval)treatment persistence in the total cohort was 3.2 years(35(29,50)months),and nearly half of patients withdrew from treatment within 5 years.The time duration was strikingly decreased in patients who were older than 40 years compared to younger patients(＜40 years:39(31,62)months,≥ 40 years:25(20,50)months,P=0.013).Patients with low erythrocyte sedimentation rate(ESR)concentrations(＜25 mm·h-1)at biologics initiation were treated longer than with a high concentration(≥ 25 mm·h-1)(P=0.06).Among the 100 patients who withdrew from therapy,treatment failure was the condition for 56％,disease remission was the condition for 18％,and adverse drug reactions were the condition for 17％to withdrawal from therapy.C-reactive protein level at biologics initiation was identified as the independent predictor for treatment failure in anti-TNF therapy(HR:1.03,95％CI:1.01-1.04,P=0.009).CONCLUSION Long-term treatment persistence of biologics therapy was limited in patients with IBD,primarily due to treatment failure,remission and adverse drug reactions.关键词
肿瘤坏死因子α拮抗剂/维得利珠单抗/炎症性肠病/治疗持久性Key words
tumor necrosis factor a antagonist/vedolizumab/inflammatory bowel diseases/treatment persistence引用本文复制引用
陈春燕,丁振东,吴巧艳,朱素燕..肿瘤坏死因子α拮抗剂和维得利珠单抗治疗炎症性肠病的持久性及影响因素[J].中国临床药学杂志,2024,33(8):598-604,7.基金项目
浙江省医药卫生科技计划项目(编号2023RC259) （编号2023RC259）
宁波市自然科学基金(编号2023J166) （编号2023J166）
