- 作者：Takuya Yoshino ; Hiroshi Nakase ; Naoki Minami ; Satoshi Yamada ; Minoru Matsuura ; Shujiro Yazumi ; Tsutomu Chiba
- 关键词：Corticosteroids ; Granulocyte and monocyte adsorption apheresis ; Ulcerative colitis
- 刊名：Digestive and Liver Disease
- 出版年：March, 2014
- 年：2014
- 卷：46
- 期：3
- 页码：219-226
- 全文大小：1413 K
Background
Safe and effective treatments are required for patients with ulcerative colitis. It was suggested that granulocyte and monocyte adsorption apheresis might play an important role for ulcerative colitis. Therefore, a meta-analysis was performed.Methods
Medline and the Cochrane controlled trials register were used to identify randomized controlled trials comparing granulocyte and monocyte adsorption apheresis with corticosteroids, and comparing intensive with conventional apheresis in patients with ulcerative colitis.
Results
Nine randomized trials were eligible for inclusion criteria. According to pooled data, granulocyte and monocyte adsorption apheresis is effective for inducing clinical remission in patients with ulcerative colitis compared with corticosteroids (odds ratio, 2.23; 95% confidence interval: 1.38-3.60). However, the efficacy of granulocyte and monocyte adsorption apheresis was not dependent on the number of apheresis sessions. The intensive apheresis (鈮? sessions per week) is more effective for inducing clinical remission than weekly apheresis (odds ratio, 2.10; 95% confidence interval: 1.12-3.93). The rate of adverse events by apheresis was significantly lower than that by corticosteroids (odds ratio, 0.24; 95% confidence interval: 0.15-0.37).
Conclusion
Our meta-analysis reveals that intensive granulocyte and monocyte adsorption apheresis is a safe and effective treatment with higher rates of clinical remission and response for ulcerative colitis compared with corticosteroids.