Leukocytapheresis for steroid-dependent ulcerative colitis in clinical practice: results of a nationwide Spanish registry

Cabriada, José Luis; Domènech, Eugeni; Ibargoyen-Roteta, Nora; Hernández, Vicent; Clofent, Joan; Ginard, Daniel; Gutiérrez-Ibarluzea, Iñaki; Hinojosa, Joaquín

doi:10.1007/s00535-011-0499-2

Cited by 32 publications

(17 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…GMA is aimed at reducing the elevated and activated leucocytes known to be sources of inflammatory cytokines 1,3–21. In most hitherto studies, the efficacy outcomes have been promising.…”

Section: Introductionmentioning

confidence: 99%

Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China

Liu

Yao

et al. 2017

Gut and Liver

View full text Add to dashboard Cite

Background/AimsPatients 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.MethodsThis 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.ResultsThirty 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.ConclusionsThe 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.

show abstract

“…GMA is aimed at reducing the elevated and activated leucocytes known to be sources of inflammatory cytokines 1,3–21. In most hitherto studies, the efficacy outcomes have been promising.…”

Section: Introductionmentioning

confidence: 99%

Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China

Liu

Yao

et al. 2017

Gut and Liver

View full text Add to dashboard Cite

show abstract

“…El primero es la obtención de remisión completa inicial, siendo el periodo libre de recidiva significativamente mayor en este caso que en caso de lograr solo una respuesta parcial inicial. Es preciso considerar en este sentido que una cierta proporción de pacientes que inicialmente solo presentan una respuesta parcial, alcanzan la remisión tardía, a los 3-6 meses, sin otras medidas asociadas 30,35 . En los distintos estudios la eficacia de la aféresis se ha evaluado entre una semana y un mes tras la última sesión; pero la aféresis actúa de forma lenta al menos con las pautas convencionales de una sesión semanal y diversos mecanismos involucrados en ella, como la disminución en la expresión de los receptores de chemocinas o el incremento de linfocitos CD4+, se han confirmado varias semanas después de aplicar el tratamiento.…”

Section: Duración De La Respuesta Resultados a Largo Plazounclassified

“…Este es el caso del reciente registro nacional (SiMAC) donde se incluyeron 142 pacientes con CU dependiente de corticoides tratados con aféresis leucocitaria, mostrando una tasa de mejoría inicial del 68%, con un 37% de remisión clínica completa al mes de la última sesión. En el seguimiento a largo plazo el 41% del total de la cohorte tratada a los 6 meses y el 36% al año mantuvieron la remisión clínica libre de corticoides 35 . El GETECCU ha promovido un estudio controlado multicéntrico internacional, actualmente en desarrollo, que ayudará a evaluar el papel de la aféresis en este escenario.…”

Section: Colitis Ulcerosa Dependiente De Corticoidesunclassified

See 1 more Smart Citation

Aféresis en enfermedad inflamatoria intestinal. ¿Una opción válida?

Cabriada

2012

Gastroenterología y Hepatología

View full text Add to dashboard Cite

“…Previous studies exploring the clinical efficacy of GMA in active UC have shown controversial results . After the observation of absence of clinical benefit in the initial clinical trial, further evidence from another open‐label clinical trial and real‐world studies have shown that this technique may be specially effective in steroid‐dependent UC …”

Section: Discussionmentioning

confidence: 99%

The combination of granulocyte‐monocyte apheresis and vedolizumab: A new treatment option for ulcerative colitis?

Rodríguez‐Lago

Benítez

Sempere

et al. 2019

J of Clinical Apheresis

View full text Add to dashboard Cite

Objectives To assess the effectiveness and safety of combining granulocyte‐monocyte apheresis (GMA) and vedolizumab (VDZ) in patients with refractory ulcerative colitis (UC). Methods This retrospective, multicentre pilot study included all UC patients receiving both GMA and VDZ. We recorded data on GMA sessions, demographic characteristics, and clinical response. Effectiveness was assessed 1 and 6 months after finishing the GMA using the partial Mayo score, C‐reactive protein, and fecal calprotectin levels. Data were also compiled on VDZ intensification, use of new immunomodulators and colectomy during follow‐up. Results Eight patients were included (mean age 46 years; 63% female; mean disease duration, 132 months; 50% E3). GMA was started after a loss of response to VDZ in all cases (25% primary nonresponse and 75% secondary loss of response). All had previously received anti‐TNF agents. VDZ was prescribed as the second‐, third‐, or fourth‐line biologic in 37%, 50%, and 13% of cases, respectively. Patients had a mean baseline partial Mayo score of 7.5 (SD 2.1) and received a median of 15 GMA sessions (range 5‐38). After a median follow‐up of 7.5 months (IQR 5‐12), partial Mayo score decreased after 1 and 6 months (P = .01 and .06, respectively). Three patients (38%) achieved steroid‐free clinical remission and five (63%) withdrew VDZ. Colectomy rate was 38%. No adverse events were observed during the combination therapy. Conclusions This small case series suggests that combining GMA with VDZ could be a treatment option in selected cases of UC with an inadequate response to this biologic agent.

show abstract

Leukocytapheresis for steroid-dependent ulcerative colitis in clinical practice: results of a nationwide Spanish registry

Abstract: In clinical practice, apheresis allows long-term steroid-free clinical remission in up to one third of steroid-dependent UC patients, even in those with prior failure of thiopurines.

Cited by 32 publications

References 31 publications

Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China

Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China

Aféresis en enfermedad inflamatoria intestinal. ¿Una opción válida?

The combination of granulocyte‐monocyte apheresis and vedolizumab: A new treatment option for ulcerative colitis?

Contact Info

Product

Resources

About