Tanida Satoshi, Ozeki Keiji, Mizoshita Tsutomu, Kitagawa Mika, Ozeki Takanori, Tanaka Mamoru, Nishie Hirotada, Shimura Takaya, Kubota Eiji, Kataoka Hiromi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan.
J Clin Med Res. 2020 Jan;12(1):36-40. doi: 10.14740/jocmr4037. Epub 2020 Jan 6.
The use of monotherapy with intensive granulocyte and monocyte adsorptive apheresis (GMA) or a Janus kinase (JAK) inhibitor has been limited to patients with refractory ulcerative colitis (UC). The efficacy and safety of combination therapy with tofacitinib (TOF) plus intensive GMA (two sessions per week) for refractory UC have not been evaluated.
This retrospective study evaluated the 10-week efficacy of combination therapy with TOF plus intensive GMA in patients with refractory UC.
Of seven patients who received a combination therapy with TOF plus intensive GMA, 71.4% achieved clinical remission at 10 weeks. The percentages of patients with mucosal healing and complete mucosal healing at 10 weeks were 100% and 42.9%, respectively. The mean full Mayo score and endoscopic subscore at baseline were 8.71 ± 0.80 and 2.4 ± 0.2, respectively, and the corresponding values at 10 weeks were 1.57 ± 0.48 and 0.6 ± 0.2 (P < 0.01), respectively. Adverse events of an orolabial herpes and temporary increase in creatinine phosphokinase (CK) and triglyceride were observed in three patients.
Based on these outcomes, combination therapy with TOF plus intensive GMA was well tolerated and may be useful for induction of clinical remission in patients with refractory UC.
单药使用强化粒细胞和单核细胞吸附性血浆置换术（GMA）或Janus激酶（JAK）抑制剂仅限于难治性溃疡性结肠炎（UC）患者。托法替布（TOF）联合强化GMA（每周两次）治疗难治性UC的疗效和安全性尚未得到评估。
这项回顾性研究评估了TOF联合强化GMA治疗难治性UC患者10周的疗效。
在7例接受TOF联合强化GMA治疗的患者中，71.4%在10周时实现了临床缓解。10周时黏膜愈合和完全黏膜愈合的患者百分比分别为100%和42.9%。基线时平均梅奥总评分和内镜子评分为8.71±0.80和2.4±0.2，10周时相应值分别为1.57±0.48和0.6±0.2（P<0.01）。3例患者出现了口腔疱疹、肌酐磷酸激酶（CK）和甘油三酯暂时升高的不良事件。
基于这些结果，TOF联合强化GMA的联合治疗耐受性良好，可能有助于诱导难治性UC患者的临床缓解。
