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Granulocytapheresis is useful as an alternative therapy in patients with steroid-refractory or -dependent ulcerative colitis.

Abstract：

BACKGROUND:Recently, granulocyte and monocyte adsorption apheresis (GCAP) has been shown to be safe and effective for active ulcerative colitis (UC). We analyzed the safety and efficacy of GCAP (G-1 Adacolumn) in patients with steroid-refractory and -dependent UC. G-1 Adacolumn is filled with cellulose acetate carriers that selectively adsorb granulocytes and monocytes/macrophages. METHODS:Forty-four patients with UC were treated with GCAP. These patients received 5 apheresis sessions over 4 weeks. Twenty patients had steroid-refractory UC (group 1) and 10 had steroid-dependent UC (group 2). Fourteen patients who did not want readministration of steroids were treated with GCAP at the time of relapse, just after discontinuation of steroid therapy (group 3). RESULTS:Of 44 patients treated with GCAP, 24 (55%) obtained remission (CAI < or = 4), 9 (20%) showed a clinical response, and 11 (25%) remained unchanged. Only 2 of 10 patients (20%) with severe steroid-refractory UC (CAI > or = 12) achieved remission, whereas 7 of 10 patients (70%) with moderate steroid-refractory UC achieved remission (p < 0.05). The dose of corticosteroids was tapered in 9 of 10 (90%) patients with steroid-dependent UC after GCAP therapy. Twelve (86%) of 14 patients in group 3 showed an improvement in symptoms and could avoid re-administration of steroids after GCAP. No severe adverse effects occurred. CONCLUSIONS:The findings of this study suggest that GCAP may be a useful alternative therapy for patients with moderate steroid-refractory or -dependent UC, although cyclosporin A or colectomy is necessary in patients with severe UC. GCAP may also be useful for avoiding re-administration of steroids at the time of relapse. Randomized, controlled clinical trials are needed to confirm these findings.

journal_name

Inflamm Bowel Dis

journal_title

Inflammatory bowel diseases

authors

Naganuma M,Funakoshi S,Sakuraba A,Takagi H,Inoue N,Ogata H,Iwao Y,Ishi H,Hibi T

doi

10.1097/00054725-200405000-00012

keywords:

subject

Has Abstract

pub_date

2004-05-01 00:00:00

pages

251-7

issue

eissn

1078-0998

issn

1536-4844

journal_volume

pub_type

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Granulocytapheresis is useful as an alternative therapy in patients with steroid-refractory or -dependent ulcerative colitis.