Treating ulcerative colitis by Adacolumn therapeutic leucocytapheresis: Clinical efficacy and safety based on surveillance of 656 patients in 53 centres in Japan

Hibi, Toshifumi; Sameshima, Yoichi; Sekiguchi, Yukari; Hisatome, Y.; Maruyama, Fumio; Moriwaki, Kaname; Shima, Chieko; Saniabadi, Abbi R.; Matsumoto, Takayuki

doi:10.1016/j.dld.2008.11.020

Cited by 68 publications

(75 citation statements)

References 58 publications

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“…Recent multicentre postmarketing data from Japan confirm that GMA was effective in the real-life setting as well as in clinical trials, achieving an overall response of 77% in a population of UC patients, 74% of whom were on prednisone. 25 To our knowledge, our study is the first with the predefined aim of systematically investigating the relative efficacy of 5 vs. 10 apheresis treatments and has demonstrated that a 5-treatment regimen is non-inferior to 10 treatments in a broad range of patients with moderate or severe UC. Over 40% of patients achieved remission during the course of treatment, which was well tolerated.…”

mentioning

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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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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“…Open-label studies and clinical experience in Japan and Europe have suggested that cytapheresis (CAP) is safe and effective in treating UC (1,2). Although CAP is an effective modality in the treatment of active UC, the time lag before notable clinical response on scheduled therapy frequently causes a significant delay in the modification of treatment.…”

Section: Introductionmentioning

confidence: 99%

Possible Role of Early Transabdominal Ultrasound in Patients Undergoing Cytapheresis for Active Ulcerative Colitis

Yoshida¹,

Kobayashi²,

Ueno³

et al. 2011

Intern. Med.

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Background Cytaphresis (CAP) is an effective modality in the treatment of active ulcerative colitis (UC), but the time lag before a notable clinical response on scheduled therapy frequently causes a significant delay in the modification of treatment. We previously reported that the clinical response after CAP was predicted by early application of transabdominal ultrasound (TAUS), but the predictability of long-term outcome after CAP still remains uncertain. Methods Patients: Twenty-six patients with active UC who received CAP were followed for 1 year. In addition to CAP they received pharmaceutical regimens, such as corticosteroid, 5-aminosalicylic acid, and immunomodulator, as indicated clinically. The mean UC-DAI score was 9.7 before CAP, and 3.2 at 1 year after CAP. Prognostic factor: Total colonic wall thickness was measured by TAUS at 2 to 3 weeks after the initiation of the treatment, and decrement from baseline was calculated. Early ultrasonographic response (EUR) was defined as a decrement statistically. UC-DAI score of 2 or less at 1 year was defined as sustained clinical remission. Score of 6 or more was defined as clinical relapse. Results EUR was defined as a decrement in wall thickness by at least 2.5 mm from the baseline. EUR was noted in 11 patients, and the remaining 15 did not attain EUR. Outcome measures: In the UC-DAI score measured at 1 year after initiation of treatment 90.9% of patients with EUR, whereas 40.0% with non-EUR (p<0.05) showed sustained clinical remission. Regarding relapse, within 1 year 9.1% of patients with EUR relapsed whereas 46.7% with non-EUR (p<0.05) relapsed. Conclusion Early application of TAUS may predict the long-term clinical outcome after CAP in patients with active UC.

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“…Meta-analysis has also revealed that GMA induced a clinical remission in a higher proportion of patients with UC compared with conventional medical therapy from seven randomized controlled trials [19]. One of the advantages of GMA treatment is the lower frequency of side effects compared to steroid treatment [14,18]. In addition, reduction in prednisolone dose is expected after GMA treatment.…”

Section: Introductionmentioning

confidence: 99%

“…GMA is also associated with marked increase in serum level of the anti-inflammatory cytokine, IL-10 [15]. Several studies have reported significant efficacy in patients with UC following a course of GMA [8,14,16,17,18,19,20,21]. It has been reported that the overall response (remission or significantly improvement) of GMA treatment increased from 58.5 to 77.7% [14,18,20].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have reported significant efficacy in patients with UC following a course of GMA [8,14,16,17,18,19,20,21]. It has been reported that the overall response (remission or significantly improvement) of GMA treatment increased from 58.5 to 77.7% [14,18,20]. Meta-analysis has also revealed that GMA induced a clinical remission in a higher proportion of patients with UC compared with conventional medical therapy from seven randomized controlled trials [19].…”

Section: Introductionmentioning

confidence: 99%

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Advantages of Fecal Lactoferrin Measurement during Granulocyte and Monocyte Adsorptive Apheresis Therapy in Ulcerative Colitis

et al. 2015

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Background: Fecal lactoferrin has been introduced as a useful tool for the diagnosis and monitoring of inflammatory bowel disease (IBD). The aim of this study was to assess if fecal lactoferrin can be employed to predict or estimate the effect of granulocyte and monocyte adsorptive apheresis (GMA) in ulcerative colitis (UC). Methods: This was a prospective study involving 21 patients with UC. Patients with moderately-to-severely active UC who were scheduled to undergo GMA were recruited. Changes in fecal lactoferrin concentration were compared between the GMA-responder and -nonresponder groups. Results: In the GMA-responder group, fecal lactoferrin significantly increased 1 week after the introduction of GMA and then significantly decreased after GMA sessions. Fecal lactoferrin concentrations were significantly higher in the GMA-responder group than in the GMA-nonresponder group at 1 and 2 weeks after the introduction of GMA. Multivariate logistic regression analysis revealed that fecal lactoferrin concentration 1 week after the introduction of GMA was the most contributing factor for the effectiveness of GMA in patients with UC. Conclusions: In the GMA-responder group, fecal lactoferrin concentration significantly increased 1 week after the introduction of GMA. Fecal lactoferrin may be beneficial for predicting clinical response of GMA in patients with UC at an early stage of GMA treatment.

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Treating ulcerative colitis by Adacolumn therapeutic leucocytapheresis: Clinical efficacy and safety based on surveillance of 656 patients in 53 centres in Japan

Cited by 68 publications

References 58 publications

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

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

Possible Role of Early Transabdominal Ultrasound in Patients Undergoing Cytapheresis for Active Ulcerative Colitis

Advantages of Fecal Lactoferrin Measurement during Granulocyte and Monocyte Adsorptive Apheresis Therapy in Ulcerative Colitis

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