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Scand J Gastroenterol. 2018 Apr;53(4):442-448. doi: 10.1080/00365521.2018.1447598. Epub 2018 Mar 7.

Granulocyte/monocyte adsorptive apheresis for the treatment of therapy-refractory chronic active ulcerative colitis.

Author information

1
a Department of Gastroenterology, Hepatology, Oncology and Metabolic Diseases , Markus-Krankenhaus , Frankfurt/Main , Germany.
2
b IBD Unit, St. Mark's Hospital and Academic Institute , London , UK.
3
c Department of Medicine, Division of Gastroenterology and Hepatology , Charité Medical Center - Virchow Hospital, Medical School of the Humboldt-University of Berlin , Berlin , Germany.
4
d Service Hépatologie-Gastroentérologie, CHU Clermont-Ferrand , Clermont-Ferrand , France.
5
e Service des Maladies de l'Appareil Digestif et CIC1414, University Hospital of Rennes , Pontchaillou , France.
6
f Service d'Hépato-gastro-entérologie, CHU du Reims, Hôpital Robert Debré , Reims Cedex , France.
7
g Herz-Jesu-Krankenhaus, Hiltrup GmbH , Münster , Germany.
8
h Assistance Publique Hôpitaux de Marseille , Marseille , France.
9
i Barts Health NHS Trust, Whipps Cross University Hospital , London , UK.
10
j Cheltenham General Hospital , Gloucestershire , UK.
11
k Service Hepato-Gastro-Enterologie, CHU Le Bocage , Dijon , France.
12
l Hôpital Rangueil, Pôle Digestif , Toulouse , France.
13
m Clinical Diagnostic Unit, Queens Hospital , Romford , UK.
14
n Clinic for Nephrology, Dialysis and Apheresis , Rostock , Germany.
15
o Kriesklinikum Siegen , Siegen , Germany.
16
p Department of Gastroenterology , Royal Liverpool University Hospital , Liverpool , UK.
17
q Medizinische Klinik - Gastroenterologie Kreisklinik , Biberach , Germany.
18
r Clinique Universitaire d'Hépato-Gastroentérologie, CHU Grenoble , Grenoble , France.

Abstract

OBJECTIVES:

Current options for patients with steroid-dependent, chronic-active ulcerative colitis (UC) with insufficient response/intolerance to immunosuppressants (ISs) and/or biologics are limited. The aim of this study was to assess the long-term outcome of granulocyte/monocyte adsorptive (GMA) apheresis (Adacolumn®) in this population.

MATERIALS AND METHODS:

Ninety five adults with steroid-dependent active UC and insufficient response/intolerance to IS and/or TNF inhibitors received 5-8 aphereses in a single induction series of ≤10 weeks. Endpoints included rates of remission (clinical activity index [CAI] ≤ 4) at weeks 24 and 48.

RESULTS:

Of 94 patients (ITT population), remission and response rates were 34.0% and 44.7% at week 24, and 33.0% and 39.4% at week 48. Among 30 patients with prior failure of IS and biologics, 33.3% and 20.0% were in remission at weeks 24 and 48. At both weeks, 19.2% of patients achieved steroid-free remission. Sustained remission or response occurred in 27.7% of patients at 48 weeks. The cumulative colectomy rate at week 96 was 23.4%. Safety was consistent with previous findings.

CONCLUSIONS:

This study confirms findings of the 12-week interim analysis and demonstrates that GMA apheresis provides a safe and beneficial long-term outcome for patients with chronic active UC resistant/intolerant to IS and/or TNF inhibitors.

KEYWORDS:

Ulcerative colitis; devices; granulocyte/monocyte adsorptive apheresis; inflammatory bowel disease; large intestine

PMID:
29513111
DOI:
10.1080/00365521.2018.1447598
[Indexed for MEDLINE]

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