潰瘍性大腸炎に対する血球成分除去療法

概要

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We have conducted two separate prospective multicenter randomized controlled studies for ulcerative colitis (UC) by placing patients into one of the following groups : (1)A high-dose prednisolone therapy (h-PSL), (2)monocyte-granulocytapheresis (M-GCAP), (3)different h-PSL group and (4)leukocytapheresis (LCAP). Effectiveness was 58.5% (31/53) in the (2)M-GCAP group, 46.2% (24/52) in the (1)h-PSL group, 74.4% (29/39) in the (4)LCAP group and 37.8% (14/37) in the (3)h-PSL group. The incidence of adverse effects to therapy was 10.2% (6/59) in the (2)M-GCAP group, 41.1% (23/56) in the (1)h-PSL group (I), 25.6% (10/39) in the (4)LCAP group and 70.3% (26/37) in the (3)h-PSL group (II). Usefulness of the therapy, which was decided by the overall effectiveness and incidence of adverse effects was 58.5% (31/53) in the (2)M-GCAP group, 44.2% (23/52) in the (1)h-PSL group, 74.4% (29/39) in the (4)LCAP group and 35.1% (13/37) in the (3)h-PSL group. Thus, the study demonstrated that cytapheresis added to on-going UC drug therapy was more effective and safer than increasing the PSL dose in intensive therapy. In addition, cytapheresis enables the steroid dosage to be decreased.
日本アフェレシス学会の論文
2003-02-28