Efficacy of Granulocytapheresis for the Treatment of Active Ulcerative Colitis and Avoidance of Systemic Corticosteroid Administration

All the patients had active colitis at baseline. The median CAI (range) decreased from 8 (5–16) to 3 (0–5; p ! 0.001, Wilcoxon signed-rank test; fig. 1 ). All the patients completed the GCAP therapy Dear Sir, The infiltration of granulocytes into the colonic mucosa plays an important role in the pathogenesis of ulcerative colitis (UC), and the removal of granulocytes may be a logical therapeutic strategy. Granulocytapheresis (GCAP) is a new technique that removes a significant amount of circulating granulocytes, reducing their migration into the intestinal mucosa [1–3] . The aim of this study was to evaluate the efficacy of GCAP in outpatients with active UC prior to the administration of systemic corticosteroids, which is the standard treatment for moderate to severe UC but which sometimes causes serious adverse effects. We enrolled 16 consecutive outpatients (7 women and 9 men; age range 22–57 years) with UC who exhibited signs of acute disease but had not yet received systemic corticosteroid treatment. The disease activity was evaluated using the clinical activity index (CAI; Truelove-Witts criteria) [4] . All the patients received 5 or 10 GCAP treatments (1 treatment/week). We evaluated the patients’ statuses before and after completion of GCAP therapy. Published online: February 26, 2010