Intensive granulocyte and monocyte adsorption versus intravenous prednisolone in patients with severe ulcerative colitis: An unblinded randomised multi-centre controlled study

Hanai, Hiroyuki; Iida, Takayuki; Takeuchi, Ken; Watanabe, Fumio; Maruyama, Yasuhiko; Kageoka, Masanobu; Ikeya, Kentaro; Yamada, Masami; Kikuyama, Masataka; Iwaoka, Yasushi; Hirayama, Kazuhisa; Nagata, Seiji; Sato, Yoshihiko; Hosoda, Yoshisuke

doi:10.1016/j.dld.2008.01.007

Cited by 44 publications

(50 citation statements)

References 66 publications

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“…In three other trials, the protocol dictated that medications administered concurrently were to remain unchanged [15,17,21]. Only in the two trials by Hanai et al [19] was concurrent steroid medication increased or decreased in line with the clinical course of the disease. A significant benefit was found (RR = 3.74; 95% CI 1.94-7.22) in the rate of patients who were steroid free after 12 or 24 weeks.…”

Section: Clinical Response or Remission After 12 Weeksmentioning

confidence: 99%

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Clinical Effectiveness of Selective Granulocyte, Monocyte Adsorptive Apheresis with the Adacolumn® Device in Ulcerative Colitis

Habermalz

Sauerland

2009

Dig Dis Sci

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The purpose of this meta-analysis was to determine whether selective adsorptive granulocyte and monocyte apheresis (GMA apheresis) using the Adacolumn device can effectively reduce clinical symptoms and endoscopic signs of inflammation in patients with ulcerative colitis (UC). A comprehensive search for randomized controlled trials (RCTs) published up to May 2008 was performed. Each study's quality was evaluated, and the data reported in the results were abstracted. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using the fixed-effects model. Heterogeneity was quantified statistically and explained by the variation in the trial design. Seven RCTs including 594 patients were found, and six RCTs on active UC contributed to the main analyses. In half of the trials, GMA apheresis was compared to steroids. Only one trial was fully blinded. A response or remission after 6 weeks was achieved more often in patients treated with GMA apheresis (RR 1.42; CI 1.15-1.75). Also, after 12 weeks, GMA apheresis produced significantly higher remission rates (RR 1.41; CI 1.08-1.83), but long-term data were sparse. In the trials that compared GMA apheresis and steroids (n = 220 patients), side effects were much less frequent in the GMA apheresis groups (RR 0.19; CI 0.11-0.34). Homogeneous evidence from seven RCTs shows that GMA apheresis induces a clinical remission in a higher proportion of UC patients as compared to conventional medical therapy.

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Section: Clinical Response or Remission After 12 Weeksmentioning

confidence: 99%

“…In terms of steroid medication, an increase in dosage for patients in the control group was dictated by the study protocol in four trials [16,[18][19][20]. In three other trials, the protocol dictated that medications administered concurrently were to remain unchanged [15,17,21].…”

Section: Clinical Response or Remission After 12 Weeksmentioning

confidence: 99%

Clinical Effectiveness of Selective Granulocyte, Monocyte Adsorptive Apheresis with the Adacolumn® Device in Ulcerative Colitis

Habermalz

Sauerland

2009

Dig Dis Sci

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“…This is consistent with earlier studies of the apheresis process where studies have shown tolerability and efficacy for 5-17 or 10-treatment regimens of Adacolumn apheresis. [13][14][15] GMA has shown efficacy in severe, steroid-refractory UC, 19 moderately severe, steroid-dependent UC 20 and steroid-naïve patients. 19 One study was not able to demonstrate a benefit of apheresis over sham treatment in cases of active moderate-to-severe UC.…”

Section: Discussionmentioning

confidence: 99%

Clinical trial: five or ten cycles of granulocyte–monocyte apheresis show equivalent efficacy and safety in ulcerative colitis

Dignaß

Eriksson

Kilander

et al. 2010

Aliment Pharmacol Ther

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“…In Japan, tacrolimus [39,40] and leukocyte apheresis [41] are also widely used as second-line treatment in severe refractory UC [42]. …”

Section: Treatment and Managementmentioning

confidence: 99%

The Same Intestinal Inflammatory Disease despite Different Genetic Risk Factors in the East and West?

Lui

2016

Inflamm Intest Dis

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Background: Inflammatory bowel disease (IBD) is a chronic inflammatory disease with unknown etiology. It is likely caused by a complex interplay between genetic, immunologic and environmental factors. Although IBD is still relatively uncommon in Asia, a multitude of studies have shown that it is an emerging disease around the world. Recent insights have highlighted both the similarities and differences amongst Asian and Western IBD patients. Summary: The annual incidence of IBD in the East is still low compared with the West, but there are differences between different regions of Asia. Time trend studies have shown that the incidence of IBD is on the rise. Some notable differences in the clinical manifestations of IBD between the East and West have also been noted. ‘Westernization' of lifestyle may encompass various social and environmental changes that account for the emergence of IBD in our population, although genetics also plays a role in disease pathogenesis. Diagnosis and treatment challenges include limited access to medical care in certain areas, limited availability and high cost of medications, lack of insurance reimbursement, paucity of multidisciplinary teams for the management of complicated IBD cases, and a high prevalence of endemic infections. Currently, the risk of colorectal cancer is lower in the East than in the West, but cancer rates will likely approach that of the West in the future as the prevalence of IBD continues to rise. Key Messages: Measures to improve access to diagnostic tools, increase the availability of medication, and provide adequate multidisciplinary care for IBD patients will become increasingly important in Asia. Differences between the East and West will provide a unique opportunity for global collaboration in basic and clinical research to further our understanding of the disease entity and also provide more locoregional data to healthcare providers and policymakers to make informed decisions and policy changes when tackling the rising burden of IBD in Asia.

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Intensive granulocyte and monocyte adsorption versus intravenous prednisolone in patients with severe ulcerative colitis: An unblinded randomised multi-centre controlled study

Cited by 44 publications

References 66 publications

Clinical Effectiveness of Selective Granulocyte, Monocyte Adsorptive Apheresis with the Adacolumn® Device in Ulcerative Colitis

Clinical Effectiveness of Selective Granulocyte, Monocyte Adsorptive Apheresis with the Adacolumn® Device in Ulcerative Colitis

Clinical trial: five or ten cycles of granulocyte–monocyte apheresis show equivalent efficacy and safety in ulcerative colitis

The Same Intestinal Inflammatory Disease despite Different Genetic Risk Factors in the East and West?

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