This study examined the long-term maintenance rate after inducing remission by intensive granulocyte/monocyte adsorptive apheresis (GMA) without use of corticosteroids (CS) and GMA re-treatment efficacy in the same patients upon relapse with ulcerative colitis. Patients who achieved clinical remission and mucosal healing (MH) by first-time intensive GMA (first GMA) without CS were enrolled. The cumulative non-relapse survival rate up to week 156 was calculated. Patients with relapse during the maintenance period underwent second-time intensive GMA (second GMA) without CS. Clinical remission and MH rates following second GMA were compared to those following first GMA in the same patients. Of the 84 patients enrolled, 78 were followed until week 156 and 34 demonstrated relapse. The cumulative non-relapse survival rate by week 156 was 56.4%. Clinical remission and MH rates after second GMA did not differ from those after first GMA in the same patients (week 6: clinical remission, 100% vs 88.4%, p = 0.134; MH, 100% vs 84.8%, p = 0.074). In conclusion, MH induction by intensive GMA without use of CS in ulcerative colitis patients contributes to subsequent longterm clinical remission maintenance. GMA re-treatment efficacy was comparable to that of first GMA in the same patients who had relapse.

Aims: We evaluated the efficacy of MMX mesalazine for the induction of remission in patients with UC who insufficiently respond to pH-or time-dependent mesalazine. Methods: Retrospective data were collected from active UC patients who switched to MMX mesalazine 4.8 g/day because of an insufficient response to 3.6 g/day of pH-or 4.0 g/day of time-dependent mesalazine between December 2016 and January 2019. The efficacy of switching to MMX mesalazine was evaluated by the decrease in partial Mayo Score (pMS), which was calculated at baseline, 2, 4, 6, and 8 weeks.Remission was defined as a decrease in pMS to ≤2. Prognostic factors related to the remission rate at 8 weeks were evaluated using univariate analysis.Results: 111 patients were included in this study. Previous treatment included pH-and time-dependent mesalazine in 72 and 39 patients, respectively. The remission rate at 8 weeks was 57.7%. Concomitant local mesalazine was identified as a significant prognostic factor related to the remission rate in the univariate analysis. The incidence of side effects was 7.2%. Conclusion:Switching to MMX mesalazine 4.8 g/day in UC patients insufficiently responding to 3.6 g/day of pH-or 4.0 g/day of time-dependent mesalazine is effective and should be considered.

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