乌帕替尼治疗中至重度炎症性肠病的疗效和安全性分析

Efficacy and safety analysis of upadacitinib in the treatment of moderate to severe inflammatory bowel disease

目的本研究总结在我院接受乌帕替尼治疗的IBD患者临床资料,提供更多的中国数据,更好的指导乌帕替尼治疗中国IBD人群。方法回顾性分析2023年3月1日-2024年9月8日在中国科学技术大学附属第一医院(安徽省立医院)接受乌帕替尼治疗的11例IBD患者临床资料,对比乌帕替尼治疗前、治疗第4、第8周的血小板计数、ESR、CRP、疾病严重程度评分、内镜评分、不良反应,并计算临床应答率、临床缓解率、内镜应答率、内镜缓解率。应用SPSS 25.0软件进行统计学分析。结果乌帕替尼治疗后第4周、第8周患者的血小板、ESR、CRP均较治疗前有所下降,差异有统计学意义,第4周时临床应答率为72.72%(8/11),临床缓解率为0,UC患者临床应答率为83.33%(5/6),CD临床应答率为60%(3/5);治疗第8周时临床应答率为100%(10/10),临床缓解率为80.00%(8/10),UC患者临床应答率为100%(6/6),UC患者临床缓解率为83.33%(5/6),CD临床应答率为100%(4/4),CD临床缓解率为75%(3/4)。治疗过程中均无不良反应。有3例患者复查肠镜,均为重症UC患者,达到黏膜愈合。结论乌帕替尼对于中重度IBD患者,可以快速、有效且持续控制疾病,且安全性高。

Objective This study summarized the clinical data of IBD patients receiving upadacitinib treatment in our hospital,and provided more Chinese data to better guide the treatment of upadacitinib in Chinese IBD population.Methods Clinical data of 11 patients with IBD who received upadacitinib treatment at Anhui Provincial Hospital from March 1,2023 to September 8,2024 were retrospectively analyzed.Platelet count,ESR,CRP,disease severity score,endoscopic score,and adverse reactions were compared before treatment,at the 4th and 8th week of treatment,and clinical response rate,clinical response rate,endoscopic response rate,and endoscopic response rate were calculated.SPSS 25.0 software was used for statistical analysis.Results The platelets,ESR and CRP of patients at the 4th and 8th week after upadacitinib treatment were decreased compared with those before treatment,with statistical significance.At the 4th week,the clinical response rate was 72.72%(8/11),the clinical remission rate was 0,the clinical response rate of UC patients was 83.33%(5/6),and the clinical response rate of CD patients was 60%(3/5).At the 8th week of treatment,the clinical response rate was 100%(10/10),the clinical remission rate was 80.00%(8/10),the clinical response rate of UC patients was 100%(6/6),the clinical remission rate of UC patients was 83.33%(5/6),the clinical response rate of CD patients was 100%(4/4),and the clinical remission rate of CD was 75%(3/4).There were no adverse reactions during treatment.Three patients were re-examined by colonoscopy,all of whom were severe UC patients and achieved mucosal healing.Conclusion Upadacitinib can rapidly,effectively and sustainably control the disease in patients with moderate and severe IBD,with high safety.