2023年8月16日

披露:Melmed报告咨询AbbVie,舞台上,勃林格殷格翰集团,百时美施贵宝公司/ Celgene公司,凸肚状,詹森,美敦力公司,辉瑞,三星Bioepis赢家,武田TechLab;从辉瑞和接收研究经费。Yarur报告咨询领域,勃林格殷格翰集团,百时美施贵宝公司,Celltrion Procise inc .和武田。请参阅研究对于所有其他作者的相关财务信息披露。主题添加到邮件提醒收到一封电子邮件在发布新文章时请提供您的电子邮件地址来接收电子邮件当张贴新文章。请稍后再试。如果你继续这个问题请联系customerservice@slackinc.com。回到Healio这种联系可能导致炎性细胞因子表达的差异。炎症性肠病和更高比例的患者腹腔内脏脂肪组织是不太可能实现corticosteroid-free缓解生物制剂处理时,数据显示在胃肠病学。“尽管生物药物已大大改善了我们的患者的治疗结果与克罗恩病和溃疡性结肠炎,有的人不回应这些疗法,”安德烈斯j . Yarur医学博士,研究作者和胃肠病学和肝脏病学副教授在cedars - sinai在洛杉矶,在一个相关的新闻发布会上说。 “In our study, we found that the patients with higher amounts of internal abdominal fat were less likely to improve and experience remission from their disease.” Data derived from: Yarur AJ, et al. Gastroenterology. 2023;doi:10.1053/j.gastro.2023.06.036. Yarur and colleagues conducted a prospective, observational cohort study to assess the association between intra-abdominal visceral adipose tissue (IA-VAT) and response to three biologics. Researchers enrolled 141 adult patients with IBD who received standard dosing of infliximab (n = 52), vedolizumab (n = 46) or ustekinumab (n = 43) and compared them with 51 healthy controls. Participants were evaluated at baseline, after biologic induction (week 14 for infliximab and vedolizumab and week 16 for ustekinumab) and at week 30 of maintenance therapy for infliximab and vedolizumab and week 32 for ustekinumab. Lean mass, total adipose tissue and IA-VAT was measured at baseline. The primary outcome was corticosteroid-free deep remission (SFDR) at week 14 or 16; secondary outcomes included SFDR at week 30 or 32 and endoscopic remission at weeks 30 through 46. According to study results, 34% of participants achieved SFDR at week 14 or 16 and 40% at week 30 or 32. In the infliximab group, 32.7% achieved SFDR at week 14 and 46.3% at week 30, while 39.1% and 41.4% achieved SFDR at those time points in the vedolizumab group. In the ustekinumab group, 30.2% achieved SFDR at week 16 and 28.5% at week 32. Multivariable analysis showed higher IA-VAT (OR per percent increase = 0.4; 95% CI, 0.16-0.98), previous biologic exposure (OR = 3.499; 95% CI, 1.43-8.53) and drug levels in the highest two quartiles for each biologic (OR = 2.97; 95% CI, 1.2-7.32) were independently linked with failure to achieve SFDR at week 14 or 16. Further, failure to achieve SFDR at week 30 or 32 was independently associated with drug levels in the two lowest quartiles for each biologic (OR = 0.26; 95% CI, 0.1-0.68) and high IA-VAT (OR = 0.25; 95% CI, 0.09-0.64). Results also showed that high IA-VAT correlated with higher interleukin-6 and tumor necrosis factor among non-responders at baseline compared with responders and those with low IA-VAT. Researchers reported no differences in drug pharmacokinetics and microbiota diversity between the high and low IA-VAT groups. “We found that higher visceral adiposity was associated with higher levels of pro-inflammatory cytokines, suggesting that fat tissue promotes inflammation, the opposite of what we want, and increases resistance to biologic drug therapy,” Gil Y. Melmed, MD, MS, study author and director of IBD clinical research at Cedars-Sinai, said in the release. Yarur added: “We need to investigate drugs with different mechanisms of action, especially other small molecules, to see if our findings hold. As the prevalence of obesity and metabolic syndrome increases in our population, we need to find interventions that would improve the body composition of these IBD patients who are not currently helped by these biologic treatments.” Reference: