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활동기 궤양성 대장염에 있어서 과립구흡착요법의 전향적 다기관 연구

Other Titles
 Granulocyte and Monocyte Adsorption Apheresis in Korean Conventional Treatment-refractory Patients with Active Ulcerative Colitis: A Prospective Open-label Multicenter Study 
Authors
 김효종  ;  김주성  ;  한동수  ;  양석균  ;  함기백  ;  이우인  ;  권석운  ;  최재현  ;  김원호  ;  최규용  ;  송인성 
Citation
 Korean Journal of Gastroenterology, Vol.45(1) : 34-44, 2005 
Journal Title
Korean Journal of Gastroenterology(대한소화기학회지)
ISSN
 1598-9992 
Issue Date
2005
MeSH
Adult ; Colitis, Ulcerative/therapy* ; Female ; Granulocytes* ; Humans ; Leukapheresis* ; Male ; Monocytes*
Keywords
Ulcerative colitis ; Granulocyte and monocyte adsorption apheresis
Abstract
Background/Aims: In chronic inflammatory conditions such as ulcerative colitis (UC), the migration of granulocytes and monocytes/macrophages from the circulation into the colonic mucosa is especially important in maintaining inflammation. The aim of this trial was to assess safety and efficacy of granulocyte and monocyte adsorption apheresis in patients with moderate-to-severe UC refractory to conventional drug therapies.
Methods: Twenty-seven patients with moderate (55.6%) to severe (44.4%) active UC refractory to conventional drug therapies who had no changes in their conventional therapy regimen in the past two weeks before the recruitment were enrolled in an open-label trial. Concomitant medications were allowed, and steroids were tapered down according to the clinical activity during the course. We used an adsorptive type extracorporeal column (AdacolumnⓇ; JIMRO, Takasaki, Japan), which selectively adsorb granulocytes and monocytes. Patients took five apheresis sessions, each with 60 minutes duration for 5 consecutive weeks. The primary efficacy variables were clinical disease activity, short inflammatory bowel disease questionnaire (SIBDQ), C-reactive protein (CRP), and endoscopic scores. These variables were scored at regular intervals, and analyzed at week 7 on an intention-to-treat (ITT) principles.
Results: At 7 weeks, 70.4% of patients showed overall improvement. Clinical disease activity (p<0.0001), endoscopic score (p<0.001), and the quality of life as assessed by SIBDQ (p<0.0001) were significantly improved after the therapy. In 56.3% of concomitant steroid users, tapering down or discontinuation of steroids was possible. Treatment was well tolerated, and no severe adverse events were observed.
Conclusions: Adacolumn was very efficacious in patients with moderate-to-severe active UC refractory to conventional drug therapy, but further assessment is needed.
Files in This Item:
T200501056.pdf Download
DOI
OAK-2005-05272
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151197
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