Treatment of active steroid-refractory inflammatory bowel diseases with granulocytapheresis: Our experience with a prospective study

瞄准：与活跃的类固醇倔强的煽动性的肠疾病(IBD ) 在 14 个病人与 granulocytapheresis (GCAP ) 的使用报导我们的经验以便在完成宽恕并且维持一个长持续没有症状的时期评估它的功效。方法：疾病的活动被临床的活动索引(蔡) 和内视镜的索引(EI ) 在 ulcerative (UC ) 评估，当时由 Crohn 在 Crohn 的疾病(CD ) 的疾病活动索引(CDAI ) 。病人用 Adacolumn 系统被对待，有选择地绑在 granulocytes 和单核白血球的吸附列。GCAP 的一个会议 / 星期为 5 wk 被执行。类固醇在词首字母的脱落期间被停止。结果：所有病人完成了不显示出复杂并发症的五星期的功课。在最后会议的结束， 93% 病人显示出为 6 瞬间坚持了的疾病的临床的宽恕。在治疗的结束以后的九个月， 60% 案例维持了宽恕，当 23% 病人仍然在在 12 瞬间以后的临床的宽恕时。结论：就算我们有类固醇倔强的 IBD 的病人的数字不大，我们能断言 GCAP 很好被容忍并且有效特别在在治疗以后的开始的六个月内，在盒子的一个重要百分比。持续反应的率在 12 瞬间以后在 6 瞬间以后并且显著地稍微落下，然而，严重副作用的缺席能是为进一步评估治疗的新时间表的刺激。

AIM： To report our experience with the use of granulocytapheresis （GCAP） in 14 patients with active steroid-refractory inflammatory bowel disease （IBD） in order to evaluate its efficacy in achieving remission and maintaining a long lasting symptom-free period. METHODS： The activity of the disease was evaluated by clinical activity index （CAI） and endoscopic index （EI） in ulcerative colitis （UC）, while by Crohn＇s disease activity index （CDAI） in Crohn＇s disease （CD）. The patients were treated using the AdacolumnTM system, an adsorption column which selectively binds to granulocytes and monocytes. One session/week of GCAP was performed for 5 wk. Steroids were stopped during apheresis. RESULTS： All the patients completed the five-week course showing no complications. At the end of the last session, 93% of patients showed a clinical remission of the disease that persisted for 6 too. Nine months after the end of the treatment, 60% of the cases maintained remission, while 23% of the patients were still in clinical remission after 12 too. CONCLUSION： Even if the number of our patients with steroid-refractory IBDs was not big, we can assert that GCAP is well tolerated and effective, especially in the first six months after the treatment, in a significant percentage of cases. The rate of sustained response drops slightly after 6 mo and significantly after 12 too, however the absence of severe side effects can be a stimulus for further evaluating new schedules of treatment.