A pilot open-labeled prospective randomized study between weekly and intensive treatment of granulocyte and monocyte adsorption apheresis for active ulcerative colitis
A pilot open-labeled prospective randomized study between weekly and intensive treatment of granulocyte and monocyte adsorption apheresis for active ulcerative colitis
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DOI：
10.1007/s00535-007-2129-6
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发表时间：
2008-01-01
影响因子：
6.3
通讯作者：
Hibi, Toshifumi
中科院分区：
文献类型：
--
作者：
Sakuraba, Atsushi;Sato, Toshiro;Hibi, Toshifumi
背景资料。近年来，粒细胞和单核细胞吸附分离术(GMA)被证明对活动期溃疡性结肠炎(UC)有效。它最初的每周治疗计划对大约70%的活动期UC有效。然而，大约需要3-4周的时间才能缓解，而且更频繁的治疗方案的疗效尚未阐明。我们进行了一项试验性开放标记的前瞻性、随机、对照研究，比较了每周和强化治疗计划，在前两周每周三次治疗。方法：研究方法。30名疾病活动度中等的活动期UC患者被前瞻性地随机分配到接受原始或强化治疗方案，总共10个疗程。比较两组患者的缓解率和缓解期。比较两组不良反应发生率。结果。初始治疗组和强化治疗组诱导缓解率分别为66.7%和80%(P=0.25，NS)。缓解时间原始组为27.2天，强化组为10.7天(P=0.04)。每组(NS)各有2例出现不良反应。结论。GMA强化治疗是治疗活动期UC的一种安全有效的方法。由于它能迅速缓解，因此它可能是一种比常规每周治疗更理想的治疗方案。
Background. Recently, granulocyte and monocyte adsorption apheresis (GMA) has been shown to be effective for active ulcerative colitis (UC). Its original weekly treatment schedule is effective in about 70% of active UC. However, it takes about 3-4 weeks to achieve remission, and the efficacy of a more frequent treatment schedule has not been elucidated yet. We performed a pilot open-labeled prospective, randomized, controlled study comparing weekly and an intensive treatment schedule with three treatment sessions per week in the first 2 weeks. Methods. Thirty active UC patients with moderate disease activity were prospectively and randomly assigned to receive the original or the intensive treatment schedule for a total of ten sessions. The proportion of the patients achieving remission and the time to achieve remission among them was compared between the two groups. The incidences of adverse effects were also compared between the two groups. Results. The rate of inducing remission in the original and intensive treatment group was 66.7% and 80%, respectively (P = 0.25, NS). The time to achieve remission was 27.2 days in the original group and 10.7 days in the intensive group (P = 0.04). Adverse effects were observed in two patients in each groups (NS). Conclusions. Intensive treatment with GMA is an efficacious and safe treatment for active UC. Because it induces rapid remission, it may be a more ideal treatment regimen than the conventional weekly treatment.