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RISS 인기검색어
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- 저자 : ( Rintaro Moroi ) (검색결과 2 건)
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( Rintaro Moroi ),( Katsuya Endo ),( Katsutoshi Yamamoto ),( Takeo Naito ),( Motoyuki Onodera ),( Masatake Kuroha ),( Yoshitake Kanazawa ),( Tomoya Kimura ),( Yoichi Kakuta ),( Atsushi Masamune ),( Yo 대한장연구학회 2019 Intestinal Research Vol.17 No.1
Background/Aims: Few reports have described the long-term treatment outcomes of the anti-tumor necrosis factor-α anti body for Japanese Crohn’s disease (CD) patients. The aim of this study was to evaluate them and clarify the clinical factors that affect the long-term prognosis of the anti-tumor necrosis factor-α treatments. Methods: This was a retrospective, observational, single-center cohort study. Japanese CD patients treated with either infliximab or adalimumab as a first-line therapy were ana lyzed. The cumulative retention rates of the biologics, relapse-free survival, and surgery-free survival were analyzed using Ka plan-Meier methods. The clinical factors associated with the long-term outcomes were estimated by both the log-rank test and Cox proportional hazard model. Results: The cumulative retention rate was significantly higher in the group with a concomi tant elemental diet of ≥900 kcal/day, baseline C-reactive protein (CRP) levels <2.6 mg/dL, and baseline serum albumin levels ≥3.5 g/dL, respectively. The baseline serum albumin levels were also associated with both relapse-free and surgery-free survival. The lack of concomitant use of an elemental diet ≥900 kcal/day was identified as the only independent risk factor for the with drawal of the biologics. Conclusions: Baseline CRP levels and serum albumin levels could affect the long-term outcomes in CD patients. Concomitant elemental diet of ≥900 kcal/day could have a positive influence on clinical treatment course. (Intest Res 2019;17:94-106)
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Hisashi Shiga,Hiroshi Nagai,Yusuke Shimoyama,Takeo Naito,Rintaro Moroi,Yoichi Kakuta,Yoshitaka Kinouchi,Atsushi Masamune 대한장연구학회 2024 Intestinal Research Vol.22 No.3
Background/Aims: Vedolizumab (VDZ) is a gut-selective agent with a favorable safety profile. We aimed to assess the feasibility of elective switch from other advanced therapies to VDZ and subsequent live-attenuated vaccination while continuing VDZ in patients with inflammatory bowel diseases (IBD). Methods: We measured antibody titers specific for measles, rubella, mumps, and varicella viruses in IBD patients under immunosuppressive therapy. Those with negative titers and without vaccination history were judged unimmunized. Patients were administered vaccines while continuing VDZ or switched to VDZ if receiving other advanced therapies and then administered vaccines. Co-primary outcomes were the rate of maintaining disease severity after vaccination and the rate without vaccine-induced infection. Results: Among 107 unimmunized patients, 37 agreed to receive live-attenuated vaccines while continuing VDZ (17 patients) or after switching to VDZ (20 patients). In the 20 patients who electively switched to VDZ, disease severity was maintained except for 1 patient who developed intestinal infection. After 54 weeks, 18 patients (90%) continued to receive VDZ, excluding 2 patients who reverted to their originally administered biologics. In all 37 patients administered live-attenuated vaccines under VDZ treatment, disease severity was maintained after vaccination. Antibody titers became positive or equivocal in 34 patients (91.9%). There were no cases of vaccine-induced infection during a median observation period of 121 weeks. Conclusions: While live-attenuated vaccines are contraindicated under immunosuppressive therapy, they may be safely administered while receiving VDZ immunotherapy. Switching from other advanced therapies to VDZ and subsequently receiving live-attenuated vaccines may be a safe alternative in unimmunized patients.
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