Adjunct antibiotic combination therapy for steroid-refractory or -dependent ulcerative colitis: an open-label multicentre study

被引:35
作者
Kato, K. [1 ]
Ohkusa, T. [2 ]
Terao, S. [3 ]
Chiba, T. [4 ]
Murakami, K. [5 ]
Yanaka, A. [6 ]
Uehara, T. [7 ]
Ishii, Y. [1 ]
Soma, M. [8 ]
Tajiri, H. [9 ]
机构
[1] Nihon Univ, Sch Med, Div Res Planning & Dev, Tokyo 1738610, Japan
[2] Jikei Univ, Kashiwa Hosp, Dept Gastroenterol & Hepatol, Kashiwa, Chiba, Japan
[3] Kakogawa East City Hosp, Dept Gastroenterol, Kakogawa, Hyogo, Japan
[4] Iwate Med Univ, Dept Gastroenterol & Hepatol, Morioka, Iwate, Japan
[5] Oita Univ, Sch Med, Dept Gastroenterol, Oita 87011, Japan
[6] Univ Tsukuba, Hitachi Med Educ & Res Ctr, Ibaraki, Japan
[7] Nihon Univ, Sch Med, Dept Gastroenterol & Hepatol, Tokyo 1738610, Japan
[8] Nihon Univ, Sch Med, Div Gen Med, Dept Internal Med, Tokyo 1738610, Japan
[9] Jikei Univ, Dept Gastroenterol & Hepatol, Tokyo, Japan
基金
日本学术振兴会;
关键词
PLACEBO-CONTROLLED TRIAL; TERM-FOLLOW-UP; DOUBLE-BLIND; RESCUE THERAPY; COLONIC MUCOSA; INFLIXIMAB; CYCLOSPORINE; CIPROFLOXACIN; TACROLIMUS; INDUCTION;
D O I
10.1111/apt.12688
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background We previously demonstrated that antibiotic combination therapy is effective for induction and maintenance of ulcerative colitis (UC) remission. Aim To assess whether antibiotic combination therapy is effective for active UC refractory to or dependent on steroids in a multicentre, open-label trial. Methods We enrolled 30 patients with steroid-refractory and 64 with steroid-dependent active UC. These patients received three-times-daily by mouth amoxicillin 500mg, tetracycline 500mg and metronidazole 250mg, for two weeks, as well as conventional treatment. Symptom assessment and colonoscopic evaluation were performed before enrolment and at 3 and 12months after treatment completion. Clinical response was defined as a Lichtiger symptom score decrease in >= 3 points and clinical remission as a score <= 4. Results Nineteen of the 30 steroid-refractory (63.3%) and 47 of the 64 steroid-dependent (73.4%) patients showed a clinical response within 2weeks. At 3 and 12months, 60% and 66.6% of steroid-refractory patients, and 56.3% and 51.6% of steroid-dependent patients, respectively, achieved clinical remission. In the steroid-dependent group, 39 of the 64 patients (60.9%) were able to stop steroid therapy and remained in remission for 3months. Three (10%) steroid-refractory and four (6.3%) steroid-dependent patients underwent colectomy. Conclusions This multicentre, long-term follow-up study suggests 2week antibiotic combination therapy to be effective and safe in patients with active UC refractory to or dependent on steroids.
引用
收藏
页码:949 / 956
页数:8
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