Tacrolimus therapy as an alternative to thiopurines for maintaining remission in patients with refractory ulcerative colitis.


BACKGROUND:Although the efficacy of tacrolimus for inducing remission of refractory ulcerative colitis (UC) is established, its efficacy for maintaining remission of UC has not been evaluated. AIM:The aim of this study was to evaluate the efficacy of tacrolimus compared with thiopurines for maintaining remission in patients with refractory UC. METHODS:Twenty-four UC patients treated with tacrolimus and 34 treated with thiopurines to maintain remission were enrolled as the tacrolimus group and the thiopurine group, respectively. In the tacrolimus group, 82.8% of the patients were treated with tacrolimus for induction of the remission, whereas 70% of the patients in the thiopurine group were induced remission with either corticosteroid or cytapheresis. Proportions of patients who kept steroid-free remission between the tacrolimus and the thiopurine groups were compared. Maintenance of remission using tacrolimus or thiopurines was defined as no need for other therapies other than aminosalicylates without relapse for at least 3 months. Secondarily, to determine whether the response to thiopurines affects the long-term efficacy of tacrolimus maintenance therapy, the overall cumulative relapse-free survival based on the Kaplan-Meier method was estimated in thiopurine-naive or thiopurine-intolerant patients and thiopurine-refractory ones in the tacrolimus group. RESULTS:Remission was successfully maintained in 17 patients (70.8%) of the tacrolimus group, and 28 patients (82.4%) of the thiopurine group. The overall cumulative relapse-free survival of thiopurine-naive or thiopurine-intolerant patients in the tacrolimus group was similar to that in the thiopurine group, and significantly higher than that of thiopurine-refractory patients in the tacrolimus group. CONCLUSION:Maintenance therapy with tacrolimus for patients with UC could be considered an alternative to thiopurine therapy.


J Clin Gastroenterol


Yamamoto S,Nakase H,Matsuura M,Masuda S,Inui K,Chiba T




Has Abstract


2011-07-01 00:00:00












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    abstract::Liver dysfunction in hyperthyroid patients has not been well characterized. We analyzed the clinical records of 43 patients with hyperthyroidism to define the spectrum of clinical and liver test abnormalities. The patients were divided into three categories: (a) 18 patients with uncomplicated hyperthyroidism (HT) (b) ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Fong TL,McHutchison JG,Reynolds TB

    更新日期:1992-04-01 00:00:00

  • Digital Chromoendoscopy With i-Scan for In Vivo Prediction of Advanced Colorectal Neoplasia: A Multicenter Study.

    abstract:BACKGROUND:Recent studies have analyzed the potential of advanced endoscopic imaging techniques for differentiating hyperplastic and adenomatous colorectal lesions. Latest endoscopic resection techniques now also allow for treatment of more advanced staged lesions including treatment of early cancerous lesions. AIMS:T...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,多中心研究


    authors: Albrecht H,Nägel A,Tasdelen H,Rath T,Grauer M,Vieth M,Neurath MF,Neumann H

    更新日期:2016-11-01 00:00:00

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    abstract::A 41-year-old man, who in 1969 had Crohn's disease and extensive hepatic and renal amyloidosis, has done well for 19 years after intestinal resection, with regression of massive proteinuria and maintenance of normal renal and hepatic function tests, although renal amyloidosis persists. ...

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    authors: Mandelstam P,Simmons DE,Mitchell B

    更新日期:1989-06-01 00:00:00

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    abstract::Several epidemiologic studies of Crohn's Disease (CD) from the northern hemisphere show high rates of the disease among Jews. Israel has absorbed many Jews from those countries and the rates of CD in Israel are lower than in their place of birth. Important, too, among immigrants from the middle east Mediterranean coun...

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    authors: Hayat JO,Yazaki E,Moore AT,Hicklin L,Dettmar P,Kang JY,Sifrim D

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    authors: Alagaratnam TT,Wong J

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    journal_title:Journal of clinical gastroenterology

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    authors: DeLuca VA Jr,West AB,Haque S,Katz DL,Ciarolla D,Goldenberg S,Fette G

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    abstract:GOAL:To study the rate at which Helicobacter pylori infection is treated in an immigrant cohort after diagnosis by esophagogastroduodenoscopy (EGD). BACKGROUND:Gastric cancer is the second leading cause of cancer death worldwide, and is especially prevalent in East Asia; immigrants from this part of the world remain a...

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    journal_title:Journal of clinical gastroenterology

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    authors: Mori K,Nagakawa T,Ohta T,Nakano T,Kadoya N,Kayahara M,Kanno M,Akiyama T,Ueno K,Konishi I

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    journal_title:Journal of clinical gastroenterology

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    pub_type: 杂志文章


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    pub_type: 杂志文章


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    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


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    更新日期:1995-01-01 00:00:00