PDF(Pubmed)
Abstract：
Inflammatory bowel disease (IBD) is a group of chronic disorders, including Crohn\'s disease (CD) and ulcerative colitis (UC), that contribute to inflammation of the gastrointestinal tract, manifesting as bloody diarrhea, fecal urgency, bloating, cramping, and weight loss. IBD manifests as an exacerbation of these symptoms, which medications with high side effect profiles can manage; consequently, many novel therapies, including biologics such as ustekinumab and vedolizumab, have been developed over the years. This systematic review aims to assess the safety and efficacy of ustekinumab and vedolizumab in treating inflammatory bowel disease based on a comprehensive analysis of relevant studies. A thorough literature search was conducted to identify randomized controlled trials, post hoc analyses, case reports, observational cohorts, and meta-analyses involving ustekinumab and vedolizumab as treatment in IBD patients. The selected studies were critically evaluated for their methodology, patient characteristics, and outcomes. The analysis involved twelve distinct studies investigating the impact of ustekinumab and vedolizumab on individuals afflicted with inflammatory bowel disease (IBD). The findings revealed a notable trend: ustekinumab displayed a propensity for yielding higher rates of clinical remission in patients with ulcerative colitis (UC). Moreover, one study underscored substantial reductions in endoscopic disease activity in patients with Crohn\'s disease (CD) who were on ustekinumab. Similarly, ustekinumab exhibited promising outcomes in CD patients, including swift ultrasound responses and the achievement of transmural remission, particularly among those who were new to biologic treatments. In line with this, vedolizumab demonstrated early and considerable symptomatic improvements when used to treat both UC and CD patients. While both biologics showed promising results in inducing and maintaining remission, cautious monitoring is warranted due to the potential adverse events observed in some cases. Further research with larger sample sizes and longer follow-up periods is needed to establish a comprehensive understanding of the medications\' effects on IBD patients.
摘要：
炎症性肠病（IBD）是一组慢性疾病，包括克罗恩病（CD）和溃疡性结肠炎（UC），导致胃肠道炎症，表现为血性腹泻,粪便的紧迫性，腹胀,抽筋,和减肥。IBD表现为这些症状的加重，哪些具有高副作用的药物可以管理；因此，许多新颖的疗法，包括生物制剂，如ustekinumab和vedolizumab，已经发展了多年。本系统综述旨在通过对相关研究的综合分析，评估ustekinumab和vedolizumab治疗炎症性肠病的安全性和有效性。进行了彻底的文献检索，以确定随机对照试验，事后分析，病例报告,观察队列，在IBD患者中使用ustekinumab和vedolizumab进行meta分析。选定的研究对其方法进行了严格的评估，患者特征,和结果。该分析涉及12项不同的研究，研究了ustekinumab和vedolizumab对患有炎症性肠病（IBD）的个体的影响。研究结果揭示了一个显著的趋势：ustekinumab在溃疡性结肠炎（UC）患者中表现出更高的临床缓解率的倾向。此外，一项研究强调使用ustekinumab的克罗恩病(CD)患者的内镜疾病活动度显著降低.同样，ustekinumab在CD患者中表现出有希望的结果，包括快速的超声反应和实现透壁缓解，特别是那些新的生物治疗。与此相符,当用于治疗UC和CD患者时，维多珠单抗表现出早期和相当大的症状改善。虽然两种生物制剂在诱导和维持缓解方面都显示出有希望的结果，由于在某些病例中观察到潜在的不良事件,因此需要谨慎监测.需要进一步研究更大的样本量和更长的随访期，以建立对药物对IBD患者影响的全面了解。
