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- 저자 : ( Masamichi Kimura ) (검색결과 3 건)
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( Masamichi Kimura ),( Yoshihisa Tsuji ),( Masako Iwai ),( Masahiro Inagaki ),( Ali Madian ),( Takuya Yoshino ),( Minoru Matsuura ),( Hiroshi Nakase ) 대한장연구학회 2015 Intestinal Research Vol.13 No.2
Behcet`s disease (BD) is a systemic vasculitis, while myelodysplastic syndrome (MDS) is a heterogeneous group of clonal hematologic disorders characterized by ineffective hematopoiesis. Some studies suggest a relationship between MDS and BD, especially intestinal BD, and trisomy 8 seems to play an important role in both diseases. There are several reports on patients with BD comorbid with MDS involving trisomy 8 that frequently have intestinal lesions refractory to conventional medical therapies. Tumor necrosis factor (TNF)-αis strongly involved in the pathophysiology of several autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, and BD. In addition, TNF-α plays an important role in the pathophysiology of MDS by inhibiting normal hematopoiesis and inducing the programmed cell death of normal total bone marrow cells and normal CD34+ cells. Recent clinical reports demonstrate the favorable effect of TNF-α antagonists in patients with refractory intestinal BD and in those with MDS. We present the case of a patient with intestinal BD and MDS involving trisomy 8 who was successfully treated with adalimumab. (Intest Res 2015;13:166-169)
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( Satoshi Yamada ),( Takuya Yoshino ),( Minoru Matsuura ),( Masamichi Kimura ),( Yorimitsu Koshikawa ),( Naoki Minami ),( Takahiko Toyonaga ),( Yusuke Honzawa ),( Hiroshi Nakase ) 대한장연구학회 2015 Intestinal Research Vol.13 No.3
Background/Aims: The long-term clinical outcomes of patients with bio-naive ulcerative colitis (UC) who maintain remission with thiopurine are unclear. The aim of this study was to assess the long-term efficacy and safety of maintenance treatment with thiopurine in UC patients. Methods: This was a retrospective observational cohort analysis conducted at a single center. Between December 1998 and August 2013, 59 of 87 patients with bio-naive UC who achieved remission after induction with treatments other than biologics were enrolled. Remission maintenance with thiopurine was defined as no concomitant treatment needed other than 5-aminosalicylate without relapse. We assessed the remissionmaintenance rate, mucosal healing rate, colectomy-free rate, and treatment safety in UC patients who received thiopurineas maintenance treatment. Results: The 84-month cumulative remission-maintenance and colectomy-free survival rates in the UC patients who were receiving maintenance treatment with thiopurine and 5-aminosalicylate were 43.9% and 88.0%, respectively. Of the 38 patients who underwent colonoscopy during thiopurine maintenance treatment, 23 (60.5%) achieved mucosal healing. Of the 59 patients who achieved clinical remission with thiopurine, 6 patients (10.2%) discontinued the thiopurine therapy because of adverse events. Conclusions: Our study demonstrates the long-term efficacy and safety of thiopurine treatment in patients with bio-naive UC. (Intest Res 2015;13:250-258)
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( Takuya Yoshino ),( Minoru Matsuura ),( Naoki Minami ),( Satoshi Yamada ),( Yusuke Honzawa ),( Masamichi Kimura ),( Yorimitsu Koshikawa ),( Ali Madian ),( Takahiko Toyonaga ),( Hiroshi Nakase ) 대한장연구학회 2015 Intestinal Research Vol.13 No.3
Background/Aims: Early use of biologics in patients with Crohn`s disease (CD) improves quality of life. However, the effects of the early use of immunomodulators on long-term outcomes remain unclear. This study aimed to evaluate the effects of immunomodulatorsin patients with CD. Methods: Between January 2004 and December 2011, 47 biologic-naive CD patients treated with thiopurines alone for remission maintenance were analyzed. The patients were classified into 2 groups depending on the presence or absence of digestive complications. We evaluated the efficacy of and predictive factors for thiopurine use for remission maintenance. Results: The cumulative relapse rates at 24 and 60 months were 13.7% and 35.4%, respectively. Regarding patient characteristics, there was a significant difference in patient history of surgery between the non-relapse and relapse groups (P =0.021). The cumulative relapse rate was lower in patients without a history of surgery than in those with such a history (27.2% and 52.9% at 60.0 months, respectively). Multivariate analysis suggested that the prevalence of stricturing and penetrating complications is an independent factor for relapse. The cumulative relapse rate in patients without a history ofsurgery was significantly lower in the non-stricturing and non-penetrating group than in the stricturing and penetrating group (11.8% at 85.0 months vs. 58.5% at 69.0 months; P =0.036). Conclusions: Thiopurine use might be beneficial for the long-term maintenance of remission in biologic-naive Crohn`s disease patients without digestive complications and a history of surgery. (Intest Res 2015;13:266-273)
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