Positioningtherapiesinulcerativecolitis.
溃疡性结肠炎的定位疗法
Abstract
Ulcerativecolitis(UC)isachronic,idiopathicinflammatoryboweldisease(IBD)thataffectsthelargeintestine.SeveraltherapeuticdrugclassesareavailableforthetreatmentofUC:salicylates,corticosteroids,thiopurines,calcineurininhibitors,anti-tumornecrosisfactor(TNF)agents,anti-adhesionmolecules,and,morerecently,smallmoleculesdirectedagainsttheJanuskinase(JAK)pathways,andustekinumab(antiIL12/23).Otherdrugsarecurrentlyindevelopment,andtheywillbeprobablyavailableforUCpatientsinthenearfuture.SeveraltherapeuticalgorithmshavebeenproposedforthetreatmentofUCpatients,yetthesearepredominantlybasedonexpertopinionsratherthanhigh-qualityevidence,mainlyduetothelackofhead-to-headtrials,especiallyformonoclonalantibodyandsmallmoleculetherapies.Theoptimalpositionoftherapiesinthesealgorithmsremainsunclear.Therefore,weconductedthisreviewoftheliteraturetoprovideanup-to-dateoverviewoftheavailableevidenceonthistopic.
溃疡性结肠炎(UC)是一种影响大肠的慢性特发性炎症性肠病(IBD)。目前有几种治疗UC的药物:水杨酸、皮质类固醇、硫嘌呤、CNIs(钙调磷酸酶抑制剂),抗TNF药物,抗粘附分子,以及最近针对JAK通路的小分子药物和抗IL12/23的尤特克单抗(ustekinumab)。其他药物目前正在开发中,可能会在不久用于UC患者的治疗中。已经提出了几种针对治疗UC患者的算法,但是这些算法主要基于专家意见而不是高质量的证据,这主要是由于缺乏一对一试验,尤其是针对单克隆抗体和小分子疗法。在这些算法中,对选择疗法的最佳位置仍不清楚。因此,我们通过本文以提供有关该主题的可用证据的最新概述。
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