Clinical Experience with Tumor Necrosis Factor-alpha Inhibitor Treatment for Moderate to Severe Ulcerative Colitis from a Single Institute

抗腫瘤壞死因子α在中重度潰瘍性大腸炎的臨床使用：從一家醫學中心的經驗

江世偉(Shih-Wei Chiang) ； 陳周誠(Chou-Chen Chen) ； 陳周斌(Chou-Bin Chen)

《中華民國大腸直腸外科醫學會雜誌》 31卷4期 (2020/12) Pp. 254-262

https://doi.org/10.6312/SCRSTW.202012_31(4).10914

摘要

Topic. The clinical experience with tumor necrosis factor-alpha (TNF-α) inhibitor treatment for moderate to severe ulcerative colitis from a single institute. Purpose. To review experiences from a single hospital in treating moderate to severe ulcerative colitis with a TNF-α inhibitor (golimumab). Methods. We retrospectively reviewed the clinical results [Mayo score, endoscopic score, mucosal healing rate, normal and inactive mucosal disease, serum C-reactive protein (CRP) level, serum erythrocyte sedimentation rate (ESR) level, white blood cell (WBC) count, and withdraw rate of steroid usage] of patients with moderate to severe ulcerative colitis (UC) treated in the Taichung Veterans General Hospital, Taiwan from July 1982 to October 2018. Treatment outcomes were recorded regularly in the outpatient clinic. The follow-up period included the following: (a) week 0, receive the inducing dose, (b) week 4, post-treatment follow-up 1, (c) week 14, post-treatment follow-up 2, and (d) week 38, post-treatment follow- up 3. Results. Among 107 patients diagnosed in our hospital, 23 patients (23/ 107, 21.5%) had moderate to severe UC and received golimumab treatment. We found significant decreases in patients' Mayo scores (mean score, from 9.6 to 3.7), endoscopic subscores (mean score, from 2.04 to 1), CRP level, WBC count, and ESR. The percentage of patients receiving steroids also decreased (from 95.7% to 38.9 %). Conclusion. TNF-α inhibitor therapy was effective for inducing and maintaining patients' clinical response for an average follow-up of 38 weeks.

關鍵字

Ulcerative colitis ； Anti-tumor necrosis factor-alpha ； Biologics ； Golimumab

並列摘要

潰瘍性大腸炎是一種特發性的腸道發炎疾病。近幾年在台灣的發病率已逐步上升，其中絕大部分為30歲至40歲的中壯族群。這些病人常因為需要藥物控制，甚至需服用長期類固醇，造成長期的併發症，進而影響工作。新型生物制劑的問世以來，一些觀察型研究顯示出有不錯的成效，但是台灣還尚未有完整的發表。因此我們蒐集院內中重度潰瘍性大腸炎的病人，評估使用抗腫瘤壞死因子α（golimumab）的臨床經驗，在追蹤38周的期間，達到有效的臨床反應，且減少使用類固醇的比例。

並列關鍵字

潰瘍性大腸炎 ； 抗腫瘤壞死因子α ； 生物製劑