Adsorptive Granulocyte/Monocyte Apheresis for the Maintenance of Remission in Patients with Ulcerative Colitis: A Prospective Randomized, Double Blind, Sham-Controlled Clinical Trial
Gut and Liver
; : 427-433, 2012.
Article
de En
| WPRIM
| ID: wpr-58007
Bibliothèque responsable:
WPRO
ABSTRACT
BACKGROUND/AIMS: Weekly granulocyte/monocyte adsorption (GMA) to deplete elevated and activated leucocytes should serve as a non-pharmacological intervention to induce remission in patients with ulcerative colitis (UC). This trial assessed the efficacy of monthly GMA as a maintenance therapy to suppress UC relapse. METHODS: Thirty-three corticosteroid refractory patients with active UC received 10 weekly GMA sessions as a remission induction therapy. They were then randomized to receive one GMA session every 4 weeks (True, n=11), extracorporeal circulation without the GMA column every 4 weeks (Sham, n=11), or no additional intervention (Control, n=11). The primary endpoint was the rate of avoiding relapse (AR) over 48 weeks. RESULTS: At week 48, the AR rates in the True, Sham, and Control groups were 40.0%, 9.1%, and 18.2%, respectively. All patients were steroid-free, but no statistically significant difference was seen among the three arms. However, in patients who could taper their prednisolone dose to <20 mg/day during the remission induction therapy, the AR in the True group was better than in the Sham (p<0.03) or Control (p<0.05) groups. CONCLUSIONS: Monthly GMA may potentially prevent UC relapse in patients who have achieved remission through weekly GMA, especially in patients on <20 mg/day PSL at the start of the maintenance therapy.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Bras
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Récidive
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Ulcère
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Aphérèse
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Induction de rémission
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Prednisolone
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Maladies inflammatoires intestinales
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Rectocolite hémorragique
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Salicylamides
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Études prospectives
Type d'étude:
Clinical_trials
/
Observational_studies
Limites du sujet:
Humans
langue:
En
Texte intégral:
Gut and Liver
Année:
2012
Type:
Article