K Sawada 1, N Masaki, S Hayashi, M Zeniya, T Ishikawa, H Takahashi, K Ohnishi, K Fukunaga, N Hara, T Yamamoto, T Hada, G Toda, J Viral Hepat. 2005 May;12(3):274-82.
Tag : Clinical trial
Section scientifique
Immunomodulatory effects of selective leucocytapheresis as a new adjunct to interferon-alpha2b plus ribavirin combination therapy: a prospective study in patients with high plasma HCV viraemia
In conclusion, enhanced efficacy of IFN/RBV following GMA might be attributed to a more efficient immune function and a renewed IFN signaling towards HCV.
Section scientifique
Granulocyteaphaeresis in steroid-dependent inflammatory bowel disease: a prospective, open, pilot study
E Domènech 1, J Hinojosa, M Esteve-Comas, F Gomollón, J M Herrera, G Bastida, A Obrador, R Ruiz, C Saro, M A Gassull, Spanish Group for the Study of Crohn’s Disease and Ulcerative Colitis (GETECCU)
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.
Section scientifique
Cytapheresis therapy for ulcerative colitis in three pediatric patients
Kanako Mori 1, Takao Yoshihara, Takashi Ando, Satoko Tsubai, Satoshi Matsuo, Michiko Aoyama, Tohru Yamamoto, Yoshio Kawase, J Pediatr Gastroenterol Nutr. 2004 Nov;39(5):549-51
Section scientifique
Granulocytapheresis with Adacolumn in the Treatment of Four Patients with Intractable Ulcerative Colitis
Makoto Higuchi, AkihiroShinii ,NaoshiNakamura , IaijiAkamatsu, Hideo Arakura, Tbru Ichikawa , Kazuhiko Horab ,YejiKamijo ,Ybko Kanekoi, rfetuji Kakegawa and Kendo Kiyosawa, Jpn JApheresis23 (2):189-19S,2004
Fourpatients (3men and 1 woman) with intractable ulcerative colitis(UC)were treated using granulocytapheresis (GCAP) with Adacolumn. Mean age at the first GCAP was 37.5± 11years.Mean observation
period beforeGCAP was 157± 105 months. A clinical activity index (CAI,Rachmilewitzcriteria) and Matts’
endoscopic classification were used forthe estimation. GCAP was not effective intwo cases, however it,was
very effective inthe others. TheCAI score of one male patient decreased from8 to 5,and Matts’ grade from
3 to 2,after the 5thGCAR his patient could be taken off conicosteroid and the immunosuppressant.
Then he received GCAP every month. Both his CAI score and Matts’grade had decreased to 1sixteen months
after the first GCAR Four sessions of GCAP enabled us to reduce the prednisolone dose from20 to 5 mg lday,
and loweredt heCAI score (8to4) of another male patient before tota1 colectomy, Further examination is needed of the indications, times and intervals of GCAP in the treatment of intractable
Section scientifique
Selective granulocyte and monocyte adsorptive apheresis as a first-line treatment for steroid naïve patients with active ulcerative colitis: a prospective uncontrolled study
Corticosteroid therapy of ulcerative colitis (UC) is associated with frequent adverse side effects and poor quality of life. Recently, adsorptive granulocyte and monocyte/macrophage apheresis has shown efficacy in patients with severe steroid refractory UC. The objective of this study was to investigate if, instead of corticosteroids, adsorptive leukocytapheresis has efficacy as the first-line therapy for steroid-naïve patients with active UC. Twenty patients, aged 15-49 years, with a mean clinical activity index (CAI) of 8.6 were recruited. Adsorptive leukocytapheresis was done with Adacolumn, which contains cellulose acetate beads as adsorptive carriers for granulocytes and monocytes (FcgammaR and complement receptors expressing leukocytes). Each patient received 6 to 10 leukocytapheresis sessions of 60-min duration, at 2 sessions/week. Efficacy was assessed 1 week after the last session. Post treatment, the mean CAI was 3.0 (P = 0001), and 17 of 20 patients (85%) were in remission. There were significant falls in C-reactive protein (P = 0.0003), total white cell counts (P = 0.003), neutrophils (P = 0.0029), and monocytes (P = 0.0038), an increase in lymphocytes (P = 0.001), and increases in the blood levels of soluble TNF-alpha receptors I (P = 0.0007) and II (P = 0.0045) in the column outflow (blood return to the patients). Further, at 8 months, 60% of patients had maintained their remission. No severe side effects were reported. In conclusion, adsorptive leukocytapheresis should reduce corticosteroid therapy in patients with moderate UC; cases with early-stage active disease may benefit most.
Section scientifique
Leukocyte adsorptive apheresis for the treatment of active ulcerative colitis: A prospective, uncontrolled, pilot study
Hiroyuki Hanai 1, Fumitoshi Watanabe, Ken Takeuchi, Takayuki Iida, Masami Yamada, Yasushi Iwaoka, Abby Saniabadi, Isao Matsushita, Yoshihiko Sato, Kotaro Tozawa, Hajime Arai, Takahisa Furuta, Ken Sugimoto, Ingvar Bjarnason, Clin Gastroenterol Hepatol. 2003 Jan;1(1):28-35.
The outcome of this study suggests that reduction of circulating granulocytes and monocytes results in alleviation of inflammation and promotes clinical remission in patients with severe active UC that has not responded to intensive corticosteroid treatment. These data suggest that formal controlled studies are warranted.
Section scientifique
Granulocytapheresis for Crohn’s Disease: A Report on Seven Refractory Patients
Toshiyuki Matsui, Taku Nishimura, Hiroaki Matake, Tomohiro Ohta, Toshihiro Sakurai, Tsuneyoshi Yao, Am J Gastroenterol. 2003 Feb;98(2):511-2.
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