Gut Liver.
2017 Mar;11(2):216-225. 10.5009/gnl15408.
Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China
- Affiliations
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- 1Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China. qjiaming1957@aliyun.com
- 2Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- 3The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
- 4Department of Gastroenterology, Peking University People's Hospital, Beijing, China.
- KMID: 2412187
- DOI: http://doi.org/10.5009/gnl15408
Abstract
- BACKGROUND/AIMS
Patients with active ulcerative colitis (UC) have elevated levels of activated myeloid-derived leukocytes as a source of inflammatory cytokines. The selective depletion of these leukocytes by adsorptive granulocyte/monocyte apheresis (GMA) with an Adacolumn should alleviate inflammation, promote remission and enhance drug efficacy. However, studies have reported contrasting efficacy outcomes based on patients' baseline demographic variables. This study was undertaken to understand the demographic features of GMA responders and nonresponders.
METHODS
This was a multicenter study in China involving four institutions and 34 patients with active UC. Baseline conventional medications were continued without changing the dosage. The treatment efficacy was evaluated based on the endoscopic activity index and the Mayo score.
RESULTS
Thirty of the 34 patients completed all 10 GMA treatment sessions. The overall efficacy rate was 70.59%. The receiver operating characteristic analysis showed that the area under the curve was approximately 0.766 for a Mayo score of ≤5.5 with 0.273 specificity and 0.857 sensitivity (Youden index, 0.584) for GMA responders. No GMA-related serious adverse events were observed.
CONCLUSIONS
The overall efficacy of GMA in patients with active UC who were taking first-line medications or were corticosteroid refractory was encouraging. Additionally, GMA was well tolerated and had a good safety profile.
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