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Dose‐Intensified Granulocyte‐Monocyte Apheresis in Therapy Refractory Ulcerative Colitis
Author(s) -
Schultheiß Caroline,
Weischenberg René,
Herrmann Andrea,
Haller Bernhard,
Schmid Roland M.,
Reindl Wolfgang,
Huber Wolfgang
Publication year - 2015
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12329
Subject(s) - apheresis , ulcerative colitis , refractory (planetary science) , granulocyte , medicine , leukapheresis , monocyte , immunology , platelet , biology , disease , astrobiology , genetics , stem cell , cd34
Abstract Granulocyte‐monocyte apheresis ( GMA ) is an emerging therapeutic option in active course of ulcerative colitis ( UC ). Appropriate GMA dose, including total number, frequency, and duration of the individual GMA session, is a matter of debate. It was the aim of the present study to evaluate the efficacy of a dose‐intensified GMA regimen in patients with moderately to severely active UC . A prospective open‐label, single‐center study was performed in 10 patients with active UC ( R achmilewitz C linical A ctivity I ndex [ CAI ] ≥ 8 points; R achmilewitz E ndoscopic I ndex ≥ 7 points). Patients had failed to improve after treatment with steroids and/or immunomodulators. GMA was performed twice weekly for 2 h to a maximum of 10 sessions. In each GMA session, the adsorber was changed after 1 h of treatment time. Four patients achieved remission with a CAI ≤ 4 points. Three patients had a response with an improvement of CAI of ≥3 points. Three patients showed no benefit from GMA . The quality of life score determined by the inflammatory bowel disease questionnaire‐Deutschland increased by 26 points in median. First and second filters had similar efficiency in granulocyte and monocyte adsorption. No major adverse effects were observed. Dose‐intensified GMA as reported in this study provided an encouraging short‐term response rate of 70% in patients with moderately to severely active UC not responding to standard steroid or immunomodulator therapy. Although all patients relapsed not later than 16 weeks, GMA might be useful to reduce steroid and immunomodulator usage, or to delay surgery in this patient group.