皮膚疾患に対する顆粒球吸着除去療法(<特集>皮膚難病とアフェレシス)

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  • 金蔵,拓郎
    鹿児島大学大学院医歯学総合研究科皮膚科学

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  • Granulocyte and Monocyte Adsorption Apheresis for Skin Diseases

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Granulocyte and monocyte adsorption apheresis (GCAP), an extracorporeal apheresis instrument using a column containing cellulose acetate beads, was initially approved for the treatment of ulcerative colitis. We carried out a clinical study to assess the therapeutic effectiveness of GCAP in patients with neutrophilic dermatoses such as pyoderma gangrenosum which is often associated with ulcerative colitis, Behcet's disease, Sweet's disease, pustular psoriasis, psoriatic arthropathy, cutaneous allergic vasculitis, Reiter's disease, adult onset Still's disease, and leg ulcer associated with rheumatic arthritis. The effect of GCAP on skin lesions and arthropathy was assessed in 73 and 26 patients, respectively. Of 73 patients, 63 (86.3%) benefited from GCAP. Improvement of arthropathy was observed in 21 of 26 patients (80.8%). On the basis of the results of our clinical study, a multi center study on GCAP for pustular psoriasis was designed. The study period was from December 2009 to July 2011. For this study, 11 facilities paticipated and 15 patients were enrolled. The severity index was decreased from 8.6±1.3 to 4.0±0.3 with statistical significance (p=0.0027). Adverse events were recorded in 3 patients but no severe events were observed. This multi center study clearly proved the effectiveness and safety of GCAP for pustular psoriasis.

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