Prior use of immunomodulatory drugs improves the clinical outcome of endoscopic balloon dilation for intestinal stricture in patients with Crohn's disease.
Prior use of immunomodulatory drugs improves the clinical outcome of endoscopic balloon dilation for intestinal stricture in patients with Crohn's disease.
复制标题
预先使用免疫调节药物可改善克罗恩病患者肠道狭窄的内镜球囊扩张的临床结果。
DOI：
10.1111/den.12029
复制
发表时间：
2013
影响因子：
5.3
通讯作者：
Honzawa Y
中科院分区：
文献类型：
--
作者：
Shinzaki S;他13名;Naka T;Plevy S E;Takehara T;Miyoshi E.;Miyamoto S.;Honzawa Y
背景内镜下球囊扩张术是一种很有前途的方法，可以改善克罗恩病（CD）患者的肠狭窄症状。然而，内镜球囊扩张联合免疫调节药物的长期疗效仍不清楚。本研究的目的是调查是否事先使用免疫调节药物影响的临床结果内镜下球囊扩张肠狭窄的CD. Patients和MethodsBetween 2004年1月至2011年12月，83扩张进行了25例CD。中位随访期为46个月。根据首次内镜球囊扩张时的药物将患者分为两组：早期免疫调节药物诱导组（早期IM诱导组），其中患者在扩张前已接受免疫调节药物治疗;免疫调节药物诱导后组（IM诱导后组），其中患者在扩张前尚未接受免疫调节药物治疗。我们比较了早期和IM诱导后组之间的长期累积非手术率和每例患者的平均扩张手术次数，以阐明既往使用免疫调节药物对内镜球囊扩张术临床结局的影响。结果早期IM诱导组和IM诱导后组之间每例患者的平均扩张手术次数存在显著差异。（P = 0.04），但两组间累积非手术率无显著差异（P = 0.14）。结论免疫调节药物的使用可改善CD患者内镜下球囊扩张治疗肠狭窄的临床结局。
BackgroundEndoscopic balloon dilation is a promising procedure to improve symptoms of intestinal stricture in patients with Crohn's disease (CD). However, the long‐term efficacy of endoscopic balloon dilation combined with immunomodulatory drugs remains unclear. The aim of the present study is to investigate whether prior use of immunomodulatory drugs affects the clinical outcome of endoscopic balloon dilation for intestinal stricture in CD.Patients and MethodsBetween January 2004 and December 2011, 83 dilations were carried out in 25 patients with CD. Median follow‐up period was 46 months. Patients were categorized into two groups based on their medications at the first endoscopic balloon dilation: early immunomodulatory drug‐induction group (early IM‐induction group) in which patients were already treated with immunomodulatory drugs before the dilation; and post‐immunomodulatory drug‐induction group (post‐IM‐induction group) in which patients were not yet treated withimmunomodulatory drugs before dilation. We compared the long‐term cumulative non‐surgical rate and the mean number of dilation procedures per patient between early and post‐IM‐induction groups to clarify the influence of prior use of immunomodulatory drugs on the clinical outcome of endoscopic balloon dilation.ResultsThere was a significant difference in the mean number of dilation procedures per patient between the early IM‐induction and post‐IM‐induction groups (P= 0.04), although no significant difference in the cumulative non‐surgical rate was observed between the two groups (P= 0.14).ConclusionPrior use of immunomodulatory drugs may improve the clinical outcome of endoscopic balloon dilation for intestinal stricture in CD.