医学
乌斯特基努马
内科学
炎症性肠病
维多利祖马布
小儿胃肠病
英夫利昔单抗
阿达木单抗
溃疡性结肠炎
中止
不利影响
肝病学
粪钙保护素
钙蛋白酶
托法替尼
胃肠病学
四分位间距
疾病
类风湿性关节炎
作者
Anat Yerushalmy‐Feler,Christine Olbjørn,Kaija‐Leena Kolho,Marina Aloi,Francesca Musto,Javier Martín-de-Carpi,Ana Lozano-Ruf,Dotan Yogev,Michael A. Matar,Luca Scarallo,Matteo Bramuzzo,Lissy de Ridder,Ben Kang,Christoph Norden,David C. Wilson,Christos Tzivinikos,Dan Turner,Shlomi Cohen
出处
期刊:Inflammatory Bowel Diseases
[Oxford University Press]
日期:2023-04-12
被引量:2
摘要
Abstract Background Current data on dual biologic therapy in children are limited. This multicenter study aimed to evaluate the effectiveness and safety of dual therapy in pediatric patients with inflammatory bowel disease (IBD). Methods A retrospective study from 14 centers affiliated with the Pediatric IBD Interest and Porto Groups of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition. Included were children with IBD who underwent combinations of biologic agents or biologic and small molecule therapy for at least 3 months. Demographic, clinical, laboratory, endoscopic, and imaging data were collected. Adverse events were recorded. Results Sixty-two children (35 Crohn’s disease, 27 ulcerative colitis; median age 15.5 [interquartile range, 13.1-16.8] years) were included. They had all failed previous biologic therapies, and 47 (76%) failed at least 2 biologic agents. The dual therapy included an anti-tumor necrosis factor agent and vedolizumab in 30 children (48%), anti-tumor necrosis factor and ustekinumab in 21 (34%) children, vedolizumab and ustekinumab in 8 (13%) children, and tofacitinib with a biologic in 3 (5%) children. Clinical remission was observed in 21 (35%), 30 (50%), and 38 (63%) children at 3, 6, and 12 months, respectively. Normalization of C-reactive protein and decrease in fecal calprotectin to <250 µg/g were achieved in 75% and 64%, respectively, at 12 months of follow-up. Twenty-nine (47%) children sustained adverse events, 8 of which were regarded as serious and led to discontinuation of therapy in 6. Conclusions Dual biologic therapy may be effective in children with refractory IBD. The potential efficacy should be weighed against the risk of serious adverse events.
科研通智能强力驱动
Strongly Powered by AbleSci AI