白细胞去除术在老年溃疡性结肠炎患者中的安全性和疗效：对无类固醇治疗的老年患者的影响。
Safety and efficacy of leukocytapheresis in elderly patients with ulcerative colitis: The impact in steroid-free elderly patients.
机构信息
Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
出版信息
J Gastroenterol Hepatol. 2018 Aug;33(8):1485-1491. doi: 10.1111/jgh.14116. Epub 2018 Mar 4.
BACKGROUND AND AIM
The number of elderly patients with ulcerative colitis (UC) is increasing. Several new therapies for UC have improved patient outcomes. Leukocytapheresis (LCAP) is an extracorporeal therapy for UC. However, its efficacy and safety for elderly UC patients has not been reported.
METHODS
We conducted a post hoc analysis of data from a large, prospective, observational study of LCAP, conducted at 116 medical facilities in Japan between May 2010 and December 2012. Of 847 patients included in this analysis, LCAP was used in 75 (8.9%) elderly patients (≥ 65 years) and 772 (91.1%) non-elderly patients.
RESULTS
There were no serious adverse events in the elderly, and the rate of adverse events between the non-elderly and elderly was not different. Overall rate of remission was also not different between the two groups. In patients who were not on concomitant treatment with corticosteroids, the rate of remission was significantly higher in the elderly group than in the non-elderly group (90.9% [20/22] vs 64.6% [135/209], P = 0.02).
CONCLUSIONS
Real-world data demonstrate that the safety and tolerability of LCAP were comparable in the elderly and non-elderly groups, indicating that it is well tolerated by elderly UC patients.
背景与目的
溃疡性结肠炎（UC）老年患者人数不断增加。一些针对 UC 的新疗法改善了患者的预后。白细胞吸附疗法（LCAP）是一种针对 UC 的体外治疗方法。然而，其在老年 UC 患者中的疗效和安全性尚未有报道。
方法
我们对 2010 年 5 月至 2012 年 12 月在日本 116 家医疗机构进行的一项 LCAP 大型前瞻性观察性研究的数据进行了事后分析。在这项分析中纳入的 847 例患者中，75 例（8.9%）老年（≥65 岁）患者和 772 例（91.1%）非老年患者使用了 LCAP。
结果
老年患者中无严重不良事件，且老年组和非老年组之间的不良事件发生率无差异。两组的总体缓解率也无差异。在未同时接受皮质类固醇治疗的患者中，老年组的缓解率显著高于非老年组（90.9%[20/22] vs. 64.6%[135/209]，P=0.02）。
结论
真实世界数据表明，LCAP 在老年组和非老年组中的安全性和耐受性相当，表明老年 UC 患者能够耐受 LCAP。
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