首页|Steroid-sparing strategies in the management of ulcerative colitis: Efficacy of leukocytapheresis
Steroid-sparing strategies in the management of ulcerative colitis: Efficacy of leukocytapheresis
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Active ulcerative colitis (UC) is frequently associated with infiltration of a large number of leukocytes into the bowel mucosa.Leukocytapheresis is a novel nonpharmacologic approach for active UC,in which leukocytes are mechanically removed from the circulatory system.Current data indicate that leukocytapheresis is efficacious in improving response and remission rates with excellent tolerability and safety in patients with UC.Corticosteroid therapy remains a mainstay in the treatment of active UC; however,long-term,high doses of corticosteroids usually produce predictable and potentially serious side effects.If leukocytapheresis can spare patients from exposure to corticosteroids,the risk of steroid-induced adverse events should be minimized.This may be of great benefit to patients because severe side effects of steroids seriously impair healthrelated quality of life.In this article,we reviewed cur rent evidence on whether leukocytapheresis can avoid or reduce the use of corticosteroids in the management of patients with UC.Several studies have shown that leukocytapheresis was effective for steroid-na(i)ve patients with active UC.Furthermore,both short-term and long-term studies have demonstrated the steroidsparing effects of leukocytapheresis therapy in patients with UC.Although the evidence level is not striking,the available data suggest that leukocytapheresis can avoid or reduce the use of corticosteroids in the management of UC.Large,well-designed clinical trials are necessary to more accurately evaluate the steroid-sparing effects of leukocytapheresis in the management of UC.
CorticosteroidGranulocyte and monocyte adsorptive apheresisLeukocytapheresisSteroid-na(i)ve patientsSteroid-sparing effectUlcerative colitis
Manabu Shiraki、Takayuki Yamamoto
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Inflammatory Bowel Disease Center, Yokkaichi Social Insurance Hospital, Yokkaichi,Mie 510-0016, Japan
NETL
NSTL
万方数据
维普
