Granulocyte-monocyte adsorptive apheresis in pediatric inflammatory bowel disease: Results, practical issues, safety, and future perspectives
| Autor: | M. Lindquist, J. Grönlund, V. Wewer, L. Marthinsen, M. Kalliomäki, L. Browaldh, Thomas Casswall, F. Lindgren, Petter Malmborg, T. Ruuska |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.drug_class Drug Resistance Azathioprine Disease Inflammatory bowel disease Gastroenterology Monocytes Crohn Disease Refractory Adrenal Cortex Hormones Recurrence Internal medicine medicine Humans Immunology and Allergy Child Retrospective Studies Crohn's disease business.industry Remission Induction medicine.disease Combined Modality Therapy Ulcerative colitis Infliximab Surgery Blood Component Removal Patient Compliance Corticosteroid Colitis Ulcerative Female business Immunosuppressive Agents Follow-Up Studies Granulocytes medicine.drug |
| Zdroj: | Inflammatory Bowel Diseases. 15:1049-1054 |
| ISSN: | 1078-0998 |
| DOI: | 10.1002/ibd.20859 |
| Popis: | Background: The purpose of the study was to collect data on granulocyte-monocyte adsorptive apheresis (GMA) for the treatment of corticosteroid-dependent (SD) or corticosteroid-resistant (SR) inflammatory bowel disease (IBD) in children from 3 Nordic countries to evaluate its efficacy and safety and to assess practical issues. Methods: Retrospective data on 37 children treated with GMA were collected. In all, 22 children had ulcerative colitis (UC), 13 Crohn's disease (CD), and 2 had indeterminate colitis (IC). Their mean age was 13.2 years, range 5–17 years, and mean duration of disease was 2.4 years, range 1 month to 6 years. Indication for treatment in the UC group was SD in 11 cases, SR in 6 cases, and other reasons in 5 cases. The corresponding numbers in the CD group were SD in 8 cases, SR in 2 cases, and other reasons in 3 cases. In the IC group, 1 had SD and 1 was refractory to steroids, azathioprine, and infliximab. Efficacy was evaluated by severity indices: the Pediatric Ulcerative Colitis Activity Index (PUCAI) and the Pediatric Crohn's Disease Activity Index (PCDAI) and tapering of corticosteroids. Results: PUCAI and PCDAI decreased significantly in both groups after 3 months (P = 0.0007, P = 0.025). The dosage of corticosteroid was significantly reduced in the UC group by the end of GMA (P = 0.004) and this response continued after 3 months. Relapse was seen in 2 patients with UC and 3 patients with CD after 3 months follow-up. Conclusions: GMA seems to be an effective and safe treatment in 81% of the SD or SR pediatric IBD patients, especially in those with UC. (Inflamm Bowel Dis 2009) |
| Databáze: | OpenAIRE |
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