難治性潰瘍性大腸炎に対するタクロリムス急速飽和療法の短期・長期治療成績

Short-term and Long-term Results of Tacrolimus Rapid Saturation Therapy for Intractable Ulcerative Colitis

要旨　タクロリムス（TAC）急速飽和療法により治療した，難治性潰瘍性大腸炎（UC）42例を対象に，短期治療成績・長期治療成績を検討した．平均DAIスコア11.1と重症例が多かったが，短期有効率69.0％，短期手術回避率83.0％であり，短期治療成績は良好であった．長期治療成績に関しては，80か月後の累積非手術率59.5％と，比較的多くの症例が経過観察中に手術となっていたが，TACの短期反応性が良好である群は有意に手術回避率が高かった．以上より，TACの短期治療反応性により，その後の経過をある程度予測できるものと思われた．

　We assessed the short-term and long-term results in 42 cases of intractable ulcerative colitis treated by TAC（tacrolimus）rapid saturation therapy. The mean DAI（disease activity index）score was 11.1, and many of the cases were severe, but the short-term efficacy rate was 69.0％ and the short-term surgery-avoidance rate was 81.0％, and thus the short-term results were favorable. The long-term results revealed a cumulative no-surgery rate after 80 months of 59.5％, and a relatively large number of the patients had undergone surgery during the follow-up period, however, the surgery avoidance rate was significantly higher in the group with a favorable short-term response to TAC. Based on these results, it seems possible to predict the subsequent course of intractable ulcerative colitis to some extent based on the short-term response to treatment with TAC.