Granulocyteaphaeresis in steroid-dependent inflammatory bowel disease:: a prospective, open, pilot study
Granulocyteaphaeresis in steroid-dependent inflammatory bowel disease:: a prospective, open, pilot study
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DOI：
10.1111/j.1365-2036.2004.02288.x
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发表时间：
2004-12-01
影响因子：
7.6
通讯作者：
Gassull, MA
中科院分区：
文献类型：
--
作者：
Domènech, E;Hinojosa, J;Gassull, MA
背景：非对照研究表明粒细胞剥离治疗活动期溃疡性结肠炎可能是有用的。目的：评价粒细胞剥离治疗活动期激素依赖型炎症性肠病的疗效。方法：我们对激素依赖型炎症性肠病患者进行了一项多中心、前瞻性、开放性的初步研究。所有患者开始服用泼尼松60毫克/天；一周后，开始进行为期五个疗程的粒细胞减少术(每周一次)。如果临床有改善，则每周逐渐减少类固醇剂量。以6周时激素完全停用为缓解指标。随访至少6个月，直至病情复发。结果：纳入26例患者，其中溃疡性结肠炎14例，克罗恩病12例。超过一半的人以前曾接受过免疫调节剂的治疗。溃疡性结肠炎和克罗恩病的缓解率分别为62%和70%。在中位随访12.6个月期间，8例溃疡性结肠炎患者中有6例维持临床缓解；然而，仅1例克罗恩病患者在随访6个月后仍保持缓解。结论：粒细胞减少术是炎症性肠病的一种安全的治疗选择。一个为期五个疗程的粒细胞剥离治疗方案似乎对激素依赖型溃疡性结肠炎有效，但对克罗恩病无效。
Background: Uncontrolled studies suggest that granulocyteaphaeresis might be useful in the management of active ulcerative colitis.Aim: To assess the efficacy of granulocyteaphaeresis treatment in active steroid-dependent inflammatory bowel disease.Methods: We conducted a multicentre, prospective, open, pilot study in patients with steroid-dependent inflammatory bowel disease. All patients were started on 60 mg/day of prednisone; after 1 week, a five-session programme of granulocyteaphaeresis (once per week) was started. The steroid dose was tapered weekly if there was clinical improvement. Remission was defined as an inactive clinical activity index together with complete withdrawal of steroids at week 6. The patients were followed up for at least 6 months or until disease relapse.Results: Twenty-six patients (14 ulcerative colitis, 12 Crohn's disease) were included. More than a half had been previously treated with immunomodulators. Remission was achieved in 62 and 70% of ulcerative colitis and Crohn's disease, respectively. During a median follow-up of 12.6 months, six of eight ulcerative colitis patients maintained their clinical remission; however, only one Crohn's disease patient remained in remission after the first 6 months of follow-up.Conclusions: Granulocyteaphaeresis is a safe treatment option in inflammatory bowel disease. A five-session programme of granulocyteaphaeresis seems to be efficient in the treatment of steroid-dependent ulcerative colitis, but not in Crohn's disease.