Efficacy and endoscopic prediction of cytapheresis therapy in patients with refractory and steroid-dependent ulcerative colitis
| Autor: | Makoto Inagawa, T. Arakawa, Hirokazu Yamagami, Nobuhide Oshitani, Kazuhide Higuchi, K. Watanabe, Noriko Kamata |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Colonoscopy medicine.disease Gastroenterology Ulcerative colitis Surgery Steroid dependency Apheresis Refractory Internal medicine medicine Pharmacology (medical) In patient General Pharmacology Toxicology and Pharmaceutics Adverse effect business Cytapheresis |
| Zdroj: | Alimentary Pharmacology Therapeutics Symposium Series. 2:147-152 |
| ISSN: | 1746-6342 1746-6334 |
| DOI: | 10.1111/j.1746-6342.2006.00038.x |
| Popis: | Summary Background Recently, it has been proved in Japan that granulocyte and monocyte adsorption apheresis (GCAP) and leukocytapheresis (LCAP) are effective and safe for patients with moderate to severe ulcerative colitis (UC). Aim To investigate the efficacy of GCAP and LCAP in patients with active UC, and the use of endoscopic findings in predicting efficacy, especially in refractory and steroid-dependent cases. Subjects and methods Thirty-four patients with active UC (24 refractory to conventional therapy and 10 steroid-dependent) were treated with GCAP (n = 21) or LCAP (n = 13). The patients received one or two GCAP or LCAP sessions per week for 5 consecutive weeks, with colonoscopy before and after each session. Results About 70% of the patients achieved a clinical response, and no severe adverse effects were observed. Most steroid-dependent patients or patients who had side effects due to steroids were controlled successfully. Endoscopically, 14 of 16 cases with shallow ulcers and erosion throughout the colon and 10 of 15 with deep ulcerations responded to treatment. However, three with massive ulceration of the whole mucosa did not respond. Conclusions GCAP or LCAP are valuable therapies for refractory or steroid-dependent UC, and endoscopic findings are helpful in predicting clinical effectiveness. |
| Databáze: | OpenAIRE |
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