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Clin Gastroenterology H: 他克莫司栓剂与倍氯米松栓剂在难治性溃疡性直肠炎患者中疗效相当

2020-08-06 MedSci原创 MedSci原创

5-氨基水杨酸(5-ASA)栓剂在治疗难治性的溃疡性直肠炎(UP)上效果不佳,一般需要逐步采用免疫调节剂或生物疗法进行进一步治疗。他克莫司局部治疗对难治性UP患者有效且安全。

背景与目标

5-氨基水杨酸(5-ASA)栓剂在治疗难治性的溃疡性直肠炎(UP)上效果不佳,一般需要逐步采用免疫调节剂或生物疗法进行进一步治疗。他克莫司局部治疗对难治性UP患者有效且安全,本项研究旨在比较他克莫司和激素相比疗效的优劣。

方法

研究人员进行了一项随机对照双盲研究。将85例难治性UP患者(65%为女性)随机分为两组,一组每天给予他克莫司栓剂一次(2 mg;n = 43)或另一组给予倍氯米松(3 mg; n = 42)治疗持续4周。主要结果是临床反应(Mayo评分降低3或更多)。次要结果包括临床缓解,内窥镜缓解和缓解,不良事件和生活质量。

 

结果

他克莫司组有临床反应的患者比例为63%,倍氯米松组为59%(P= 0.812);临床缓解患者的比例分别为46%和38%(P= .638)。他克莫司组和倍氯米松组内镜反应患者的比例分别为68%和60%(P= .636);内镜缓解率的比例分别为30%和13%(P= .092)。他克莫司组炎症性肠病问卷的中位数增加为18.0,倍氯米松组为20.5(P= .395)。两组之间的不良事件发生率无显着差异。

 

结论

本项研究从多个维度对他克莫司和倍氯米松栓剂对5-ASA难治性UP患者的疗效进行了比较。证明了他克莫司和倍氯米松栓剂都是5-ASA难治性溃疡性结肠炎的有效治疗选择。

原始出处:

Mitchell R.K. L. Lie. Et al. No Superiority of Tacrolimus Suppositories vs Beclomethasone Suppositories in a Randomized Trial of Patients With Refractory Ulcerative Proctitis.Clin Gastroenterology H.2020.

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    2021-03-21 nymo
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topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu Apr 08 05:16:25 CST 2021, time=2021-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=810285, encodeId=d8a0810285c7, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/08/10/b92c6fe1729451c8d4b3a5c04e1396c6.jpg, createdBy=dfe32402282, createdName=西西er, createdTime=Tue Aug 18 12:11:27 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=809528, encodeId=e05c80952850, content=非常有用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc945208979, createdName=147569a8m07暂无昵称, createdTime=Sun Aug 16 23:39:30 CST 2020, time=2020-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1337772, encodeId=a7b2133e772ca, content=<a href='/topic/show?id=fbd825321ba' target=_blank style='color:#2F92EE;'>#他克莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25321, encryptionId=fbd825321ba, topicName=他克莫司)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d0b2500136, createdName=12498b08m90暂无昵称, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505051, encodeId=ee6e1505051dc, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528678, encodeId=d7c015286e862, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=806543, encodeId=46b5806543cf, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43be5402548, createdName=ms4000000062793346, createdTime=Thu Aug 06 14:41:29 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2021-04-08 许安
  5. [GetPortalCommentsPageByObjectIdResponse(id=1695181, encodeId=b0cc169518121, content=<a href='/topic/show?id=c76e6645438' target=_blank style='color:#2F92EE;'>#溃疡性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66454, encryptionId=c76e6645438, topicName=溃疡性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=787129789891, createdName=nymo, createdTime=Sun Mar 21 04:16:25 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712501, encodeId=2ce41e1250141, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu Apr 08 05:16:25 CST 2021, time=2021-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=810285, encodeId=d8a0810285c7, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/08/10/b92c6fe1729451c8d4b3a5c04e1396c6.jpg, createdBy=dfe32402282, createdName=西西er, createdTime=Tue Aug 18 12:11:27 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=809528, encodeId=e05c80952850, content=非常有用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc945208979, createdName=147569a8m07暂无昵称, createdTime=Sun Aug 16 23:39:30 CST 2020, time=2020-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1337772, encodeId=a7b2133e772ca, content=<a href='/topic/show?id=fbd825321ba' target=_blank style='color:#2F92EE;'>#他克莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25321, encryptionId=fbd825321ba, topicName=他克莫司)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d0b2500136, createdName=12498b08m90暂无昵称, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505051, encodeId=ee6e1505051dc, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528678, encodeId=d7c015286e862, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=806543, encodeId=46b5806543cf, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43be5402548, createdName=ms4000000062793346, createdTime=Thu Aug 06 14:41:29 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2020-08-18 西西er

    了解了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1695181, encodeId=b0cc169518121, content=<a href='/topic/show?id=c76e6645438' target=_blank style='color:#2F92EE;'>#溃疡性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66454, encryptionId=c76e6645438, topicName=溃疡性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=787129789891, createdName=nymo, createdTime=Sun Mar 21 04:16:25 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712501, encodeId=2ce41e1250141, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Fri Feb 12 15:16:25 CST 2021, time=2021-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2065117, encodeId=34dc206511e84, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Mar 07 17:16:25 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2073066, encodeId=d7d420e306679, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, 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authenticateStatus=null, createdAvatar=, createdBy=bc945208979, createdName=147569a8m07暂无昵称, createdTime=Sun Aug 16 23:39:30 CST 2020, time=2020-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1337772, encodeId=a7b2133e772ca, content=<a href='/topic/show?id=fbd825321ba' target=_blank style='color:#2F92EE;'>#他克莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25321, encryptionId=fbd825321ba, topicName=他克莫司)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d0b2500136, createdName=12498b08m90暂无昵称, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505051, encodeId=ee6e1505051dc, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528678, encodeId=d7c015286e862, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=806543, encodeId=46b5806543cf, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43be5402548, createdName=ms4000000062793346, createdTime=Thu Aug 06 14:41:29 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2020-08-16 147569a8m07暂无昵称

    非常有用!

    0

  7. 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topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu Apr 08 05:16:25 CST 2021, time=2021-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=810285, encodeId=d8a0810285c7, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/08/10/b92c6fe1729451c8d4b3a5c04e1396c6.jpg, createdBy=dfe32402282, createdName=西西er, createdTime=Tue Aug 18 12:11:27 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=809528, encodeId=e05c80952850, content=非常有用!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc945208979, createdName=147569a8m07暂无昵称, createdTime=Sun Aug 16 23:39:30 CST 2020, time=2020-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1337772, encodeId=a7b2133e772ca, content=<a href='/topic/show?id=fbd825321ba' target=_blank style='color:#2F92EE;'>#他克莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25321, encryptionId=fbd825321ba, topicName=他克莫司)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d0b2500136, createdName=12498b08m90暂无昵称, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505051, encodeId=ee6e1505051dc, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528678, encodeId=d7c015286e862, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Aug 08 01:16:25 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=806543, encodeId=46b5806543cf, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43be5402548, createdName=ms4000000062793346, createdTime=Thu Aug 06 14:41:29 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
  8. 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  9. 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objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=43be5402548, createdName=ms4000000062793346, createdTime=Thu Aug 06 14:41:29 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2020-08-08 freve
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    2020-08-06 ms4000000062793346

    学习

    0

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