Extracorporeal Photopheresis for the Treatment of Refractory Crohn's Disease: Results of an Open-label Pilot Study

被引：35

作者：

Abreu, Maria T. ^{[1
]}

von Tirpitz, Christian ^{[2
]}

Hardi, Robert ^{[3
]}

Kaatz, Martin ^{[4
]}

Van Assche, Gert ^{[5
]}

Rutgeerts, Paul ^{[5
]}

Bisaccia, Emil ^{[6
]}

Goerdt, Sergi ^{[7
]}

Hanauer, Stephen ^{[8
]}

Knobler, Robert ^{[9
]}

Mannon, Peter ^{[10
]}

Mayer, Lloyd ^{[11
]}

Ochsenkuhn, Thomas ^{[12
]}

Sandborn, William J. ^{[13
]}

Parenti, Dennis ^{[14
]}

Lee, Kevin ^{[14
]}

Reinisch, Walter ^{[15
]}

机构：

[1] Univ Miami, Miller Sch Med, Miami, FL 33136 USA

[2] Univ Ulm, Dept Digest Dis, Ulm, Germany

[3] Chevy Chase Clin Res, Chevy Chase, MD USA

[4] Univ Jena, Dept Gastroenterol, Jena, Germany

[5] Univ Leuven, Dept Internal Med, Dept Gastroenterol, Louvain, Belgium

[6] Morristown Mem Hosp, Morristown, NJ USA

[7] Univ Mannheim, Dept Gastroenterol, Mannheim, Germany

[8] Univ Chicago, Div Gastroenterol Hepatol & Nutr, Chicago, IL 60637 USA

[9] Univ Vienna, Dept Dermatol, Vienna, Austria

[10] NIAID, Bethesda, MD 20892 USA

[11] Mt Sinai Sch Med, Inst Immunol, New York, NY USA

[12] Univ Munich, Dept Gastroenterol, Munich, Germany

[13] Mayo Clin, Div Gastroenterol & Hepatol, Rochester, MN USA

[14] Therakos Inc, Exton, PA USA

[15] Univ Vienna, Dept Gastroenterol, Vienna, Austria

来源：

INFLAMMATORY BOWEL DISEASES | 2009年 / 15卷 / 06期

关键词：

extracorporeal photopheresis; 8-methoxypsoralen; anti-TNF therapy; immunomodulators; Crohn's disease; VERSUS-HOST-DISEASE; REGULATORY T-CELLS; CERTOLIZUMAB PEGOL; APOPTOTIC CELLS; LONG-TERM; PHOTOCHEMOTHERAPY; INFLIXIMAB; LYMPHOMA; THERAPY; 6-MERCAPTOPURINE;

D O I：

10.1002/ibd.20833

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Extracorporeal photopheresis (ECP) is effective in immune-mediated disorders. A prospective, uncontrolled pilot study was conducted to evaluate the safety and efficacy of ECP in patients with active Crohn's disease (CD) who were refractory to or intolerant of immunosuppressants and/or anti-TNF therapies. Methods: Patients with moderate-to-severely active CD (Crohn's Disease Activity Index [CDAI] 220-450 points) underwent 12 weeks of ECP treatment (Weeks 1-4: twice weekly, every week; Weeks 5-12: twice weekly, every other week). Clinical response was defined as a decrease in the CDAI of : 100 points or remission (CDAI < 150 points) at Week 12. Patients who responded at Week 12 could receive an additional 12 weeks of ECP treatment (twice weekly, every other week) in an extension Study. Results: Twenty-eight patients were enrolled with a mean baseline CDAI score of 314 (range 207-457). At Week 12, 14 patients (50%) responded; 13 patients responded within 6 weeks. Seven patients (25%) attained remission by Week 12. Three of 5 patients with open fistulae at baseline had fistula closure. Response was similar among patients naive to anti-TNF agents and patients who had previously been refractory or intolerant to anti-TNF agents. Of the 12 patients who entered the extension study, 9 (75%) maintained their response at Week 24. Conclusions: In patients with moderate-to-severely active CD who were refractory to or intolerant of immunosuppressants and/or anti-TNF agents, ECP was well tolerated and induced clinical response (50%) and remission (25%) in patients. Most patients were able to maintain a response with Continued treatments.

引用

页码：829 / 836

页数：8

共 39 条

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