METHODS: Retrospective study including all patients with refractory UC who received GMA plus TOFA. Efficacy was assessed 1 and 6 months after finishing GMA by partial Mayo score, C-reactive protein (CRP) and fecal calprotectin (FC). Descriptive statistics and non-parametric tests were used in the statistical analysis.
RESULTS: Twelve patients were included (median 46 years [IQR, 37-58]; 67% female; 67% E3). Patients were mostly receiving TOFA 10mg bid (75%), and 33% also concomitant steroids at baseline. Median partial Mayo score at baseline was 7 (IQR, 5-7), and it decreased to a median of 2 (IQR, 0-3) and 0 (IQR, 0-3) after 1 and 6 months (p=0.027 and 0.020, respectively), while no differences were found in CRP and FC. Clinical remission was achieved by 6 patients both at 1 (50%) and 6 months (67%). CF values<250mg/kg were achieved by 2 and 4 patients at 1 and 6 months (data available in 5 and 7 patients, respectively). No patient required dose-escalation of TOFA, and one patient was able to de-escalate the drug. No patient required colectomy and all patients under steroids were able to stop them.
CONCLUSIONS: The combination of GMA and TOFA can be effective in selected cases of UC after PNR or LOR to this drug.
方法:回顾性研究包括所有接受GMA加TOFA的难治性UC患者。通过部分Mayo评分在完成GMA后1个月和6个月评估疗效,C反应蛋白(CRP)和粪便钙卫蛋白(FC)。统计分析采用描述性统计和非参数检验。
结果:纳入12例患者(中位数46年[IQR,37-58];67%女性;67%E3)。患者大多接受TOFA10mgbid(75%),和33%也伴随类固醇在基线。基线时部分Mayo评分中位数为7(IQR,5-7),下降到中位数2(IQR,0-3)和0(IQR,0-3)在1个月和6个月后(分别为p=0.027和0.020),而CRP和FC没有发现差异。6例患者在1个月(50%)和6个月(67%)均实现了临床缓解。在1个月和6个月时,2名和4名患者的CF值<250mg/kg(5名和7名患者的数据可用,分别)。没有患者需要TOFA的剂量递增,一名患者能够降低药物的浓度。没有患者需要结肠切除术,所有接受类固醇治疗的患者都能够停止结肠切除术。
结论:GMA和TOFA的组合在选择的UC病例中PNR或LOR后对该药物有效。