scholarly journals Immunomodulators and Immunosuppressants for Japanese Patients with Ulcerative Colitis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Shigeki Bamba ◽  
Tomoyuki Tsujikawa ◽  
Masaya Sasaki ◽  
Yoshihide Fujiyama ◽  
Akira Andoh
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Importance ◽  
Japanese Patients ◽  
Multidrug Resistance Protein ◽  
Aminosalicylic Acid ◽  
Steroid Dependent ◽  
Resistance Protein ◽  
Chronic Course ◽  
Steroid Refractory

Ulcerative colitis (UC) is characterized by a long-standing chronic course with remissions and exacerbations. Previously, patients do not respond to 5-aminosalicylic acid compounds and corticosteroids are considered for colectomies, however, in recent years, alternative treatments emerged for steroid-refractory or steroid-dependent UC. In this review article, we focus on immunomodulators (such as azathioprine [AZA] and 6-mercaptopurine [6-MP]) and immunosuppressants (such as cyclosporine A [CSA] and tacrolimus [FK506]) for steroid-refractory or steroid-dependent ulcerative colitis. The characteristics, efficacy and adverse effects of these drugs are outlined. Although the randomized trial of FK506 is conducted in Japan, the clinical data of CSA in Japanese patients are limited. The short-, mid- and long-term follow-ups of CSA administration in Japanese patients are discussed. As for thipurine drugs, the clinical importance of multidrug-resistance protein 4 (MRP4) in Japanese patients is highlighted.

scholarly journals Analysis of the Long-Term Prognosis in Japanese Patients with Ulcerative Colitis Treated with New Therapeutic Agents and the Correlation between Prognosis and Disease Susceptibility Loci

2021 ◽  
pp. 1-11
Author(s):  
Kasumi Hishinuma ◽  
Rintaro Moroi ◽  
Daisuke Okamoto ◽  
Yusuke Shimoyama ◽  
Masatake Kuroha ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Multivariate Analysis ◽  
Poor Response ◽  
Japanese Patients ◽  
Therapeutic Agents ◽  
Aminosalicylic Acid ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Long Term Prognosis

<b><i>Background:</i></b> New therapeutic agents, including biologics and small-molecule drugs, are widely used to treat ulcerative colitis (UC). This study evaluates long-term prognosis in Japanese patients treated with these agents and the association between prognosis and genetic susceptibility to UC. <b><i>Methods:</i></b> We evaluated surgery-free rates using the Kaplan-Meier method in the total cohort and in patients treated with prednisolone and new therapeutic agents. Multivariate analysis was performed to identify clinical factors affecting surgical rates using Cox’s proportional hazard model. The rate of use of new therapeutic agents was compared using the Kaplan-Meier method, and multivariate analysis was conducted to investigate the correlation between the single-nucleotide polymorphism (SNP) rs117506082 and long-term prognosis. <b><i>Results:</i></b> Surgery-free survival decreased over time. There was no significant difference in this parameter between patients who were administered prednisolone and those who were administered new therapeutic agents. Poor response to prednisolone and treatment without topical 5-aminosalicylic acid were poor prognostic factors. Shorter time from diagnosis to initiation of treatment with new therapeutic agents was a risk factor for colectomy. The AA genotype of SNP rs117506082 was associated with a shorter time to surgery and increased use of new therapeutic agents. <b><i>Conclusions:</i></b> The use of new therapeutic agents might improve long-term prognosis in patients with more severe UC. Previously identified genetic risk factors were not significantly associated with a higher rate of colectomy.

scholarly journals Long-term Outcomes in Steroid-refractory Ulcerative Colitis Treated with Tacrolimus Alone or in Combination with Purine Analogues

2015 ◽  
Vol 10 (1) ◽  
pp. 31-37 ◽  
Author(s):  
K. J. Schmidt ◽  
N. Müller ◽  
A. Dignass ◽  
D. C. Baumgart ◽  
H. Lehnert ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Long Term Outcomes ◽  
Purine Analogues ◽  
Steroid Refractory

scholarly journals A Comparison of Short- and Long-Term Therapeutic Outcomes of Infliximab- versus Tacrolimus-Based Strategies for Steroid-Refractory Ulcerative Colitis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Katsuya Endo ◽  
Motoyuki Onodera ◽  
Hisashi Shiga ◽  
Masatake Kuroha ◽  
Tomoya Kimura ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Therapeutic Efficacy ◽  
Maintenance Treatment ◽  
Remission Rate ◽  
Rank Test ◽  
Clinical Response Rate ◽  
Therapeutic Outcomes ◽  
Significant Difference ◽  
Steroid Refractory

Background/Aims. Antitumor necrosis factor antibodies and calcineurin inhibitors have shown good therapeutic efficacy for steroid-refractory ulcerative colitis (UC). Although some studies have compared the efficacy of infliximab (IFX) and cyclosporin A, there are no published studies comparing IFX and tacrolimus (Tac). This study aimed to compare therapeutic efficacies between IFX- and Tac-based strategies for steroid-refractory UC.Methods. Between July 2009 and August 2013, 95 patients with steroid-refractory UC received either IFX(n=48)or Tac(n=47)in our hospital. In the IFX group, the patients continued to receive maintenance treatment with IFX. In the Tac group, patients discontinued Tac treatment up to 3 months and subsequently received thiopurine. We retrospectively compared the therapeutic outcomes between the groups.Results. There was no significant difference in the colectomy-free rate, clinical remission rate, and clinical response rate at 2 months between the groups. However, relapse-free survival was significantly higher in the IFX group than in the Tac group (p<0.001; log-rank test). The proportions of serious adverse events did not differ between the groups.Conclusion.The findings of our study showed that IFX and Tac have similar short-term therapeutic efficacy for steroid-refractory UC. Maintenance treatment with IFX, however, yields better long-term outcomes than Tac-thiopurine bridging treatment.

scholarly journals Exploratory Study of the Effectiveness of Granulocyte and Monocyte Adsorptive Apheresis Before Initiation of Steroids in Patients With Active Ulcerative Colitis (EXPECT Study): A Multicenter Prospective Clinical Trial

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Kazuki Kakimoto ◽  
Minoru Matsuura ◽  
Takumi Fukuchi ◽  
Hitoshi Hongo ◽  
Tsuguhiro Kimura ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Trial ◽  
Exploratory Study ◽  
Response Rate ◽  
Mucosal Healing ◽  
Prospective Clinical Trial ◽  
Aminosalicylic Acid ◽  
Open Label ◽  
Steroid Dependent ◽  
Adsorptive Apheresis

Abstract Background Granulocyte and monocyte adsorptive apheresis (GMA) has been used for therapy of steroid-dependent/refractory ulcerative colitis (UC). The aim of this study was to investigate the effectiveness of GMA in UC patients not receiving steroids. Methods We conducted a single-arm, open-label, and multicenter prospective clinical trial. UC patients who had insufficient responses to 5-aminosalicylic acid received GMA twice a week for 5 weeks. Results The response rate of all patients was 58.2% (39/67). Of the 39 patients who achieved a response, 74.4% achieved endoscopically confirmed mucosal healing. Conclusions GMA shows effectiveness in inducing remission in UC patients not receiving steroid.

Sulphasalazine and 5-aminosalicylic acid in long-term treatment of ulcerative colitis: report on tolerance and side-effects

2001 ◽  
Vol 33 (7) ◽  
pp. 563-569 ◽  
Author(s):  
M.C. Di Paolo ◽  
O.A. Paoluzi ◽  
R. Pica ◽  
F. Iacopini ◽  
P. Crispino ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Side Effects ◽  
Term Treatment ◽  
Aminosalicylic Acid ◽  
Long Term Treatment

W1101 Infliximab Can Prevent Immediate Surgery in Steroid Refractory Ulcerative Colitis, But May Not Be the Long-Term Answer

2009 ◽  
Vol 136 (5) ◽  
pp. A-654
Author(s):  
Edel McDermott ◽  
Eoin Slattery ◽  
Denise Keegan ◽  
Sinead McDermott ◽  
Hugh Mulcahy ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Immediate Surgery ◽  
Steroid Refractory
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