{"id":9960,"date":"2024-01-29T12:59:00","date_gmt":"2024-01-29T11:59:00","guid":{"rendered":"https:\/\/www.adacyte.com\/?post_type=scientific-corner&#038;p=9960"},"modified":"2024-03-27T13:06:43","modified_gmt":"2024-03-27T12:06:43","slug":"granulocyte-monocyte-macrophage-apheresis-for-steroid-nonresponsive-or-steroid-intolerant-severe-alcohol-associated-hepatitis-a-pilot-study","status":"publish","type":"scientific-corner","link":"https:\/\/www.adacyte.com\/es\/professional\/scientific-corner\/granulocyte-monocyte-macrophage-apheresis-for-steroid-nonresponsive-or-steroid-intolerant-severe-alcohol-associated-hepatitis-a-pilot-study\/","title":{"rendered":"Granulocyte-monocyte\/macrophage apheresis for steroid-nonresponsive or steroid-intolerant severe alcohol-associated hepatitis: A pilot study"},"content":{"rendered":"<div class=\"post-content max-w-987 mx-auto px-20 lg:px-0\">Ryosuke Kasuga 1, Po-Sung Chu 1, Nobuhito Taniki 1, Aya Yoshida 1, Rei Morikawa 1, Takaya Tabuchi 1, Fumie Noguchi 1, Karin Yamataka 1, Yukie Nakadai 1, Mayuko Kondo 1, Hirotoshi Ebinuma 1 2, Takanori Kanai 1, Nobuhiro Nakamoto 1<\/p>\n<p>Background: Patients with severe alcohol-associated hepatitis (SAH) have a high short-term mortality rate. Unmet needs exist in patients who are refractory to corticosteroids (CS) or are ineligible for early liver transplantation.<\/p>\n<p>Methods: This was a prospective, open-label, nonrandomized pilot study conducted at a liver transplant center in Tokyo, Japan, starting in October 2015. Lille model and Model for End-stage Liver Disease (MELD) score-defined CS nonresponsive or CS-intolerant patients with SAH who fulfilled the inclusion criteria (leukocytosis over 10,000\/\u03bcL, etc.) were considered for enrollment. The median duration from admission to enrollment was 23 days (IQR, 14-31 days), after standard of care. Granulocyte-monocyte\/macrophage apheresis (GMA) performed with Adacolumn twice per week, up to 10 times per treatment course, was evaluated.<\/p>\n<p>Results: 13 GMA treatments were conducted through December 2021. Maddrey Discriminant Function was 53.217.7 at admission. The overall survival rate was 90.9% at 90 and 180 days. MELD scores significantly improved, from median (IQRs) of 23 (20-25) to 15 (13-21) after GMA (p<0.0001). Estimated mortality risks using the Lille model and MELD scores significantly improved from 20.9%\u00b116.5% to 7.4%\u00b17.3% at 2 months and from 30.4%\u00b121.3% to 11.6%\u00b110.8% at 6 months, respectively (both p<0.01), and were internally validated. The cumulative rate of alcohol relapse was 35.9% per year. No severe adverse events were observed. In exploratory analysis, granulocyte colony-stimulating factor levels were significantly correlated with prognostic systems such as MELD-Sodium scores after GMA (correlation coefficient= -0.9943, p<0.0001) but not before GMA (p=0.62).\n\nConclusions: Compared to published studies, GMA is associated with a lower-than-expected 90- and 180-day mortality in patients with CS-nonresponsive or CS-intolerant SAH. GMA may meet the needs as a salvage anti-inflammatory therapy for SAH. (Trial registration: UMIN000019351 and jRCTs No.032180221) (274 words).<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Ryosuke Kasuga 1, Po-Sung Chu 1, Nobuhito Taniki 1, Aya Yoshida 1, Rei Morikawa 1, Takaya Tabuchi 1, Fumie Noguchi 1, Karin Yamataka 1, Yukie Nakadai 1, Mayuko Kondo 1, Hirotoshi Ebinuma 1 2, Takanori Kanai 1, Nobuhiro Nakamoto 1 Background: Patients with severe alcohol-associated hepatitis (SAH) have a high short-term mortality rate. Unmet needs [&hellip;]<\/p>\n","protected":false},"template":"","scientific_tags":[101,157,424,465,794,793,96,174,97,792,559,605],"class_list":["post-9960","scientific-corner","type-scientific-corner","status-publish","hentry","scientific_tags-alcoholic-hepatitis","scientific_tags-efficacy","scientific_tags-gma","scientific_tags-intensive","scientific_tags-mortality-decrease","scientific_tags-non-randomized","scientific_tags-open-label","scientific_tags-pilot-study","scientific_tags-prospective","scientific_tags-sah","scientific_tags-severe","scientific_tags-steroid-refractory-2"],"acf":{"sc_authors":"<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38285891\/\">https:\/\/pubmed.ncbi.nlm.nih.gov\/38285891\/<\/a>\r\n\r\n<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10830070\/\">Granulocyte-monocyte\/macrophage apheresis for steroid-nonresponsive or steroid-intolerant severe alcohol-associated hepatitis: A pilot study - PMC (nih.gov)<\/a>"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Granulocyte-monocyte\/macrophage apheresis for steroid-nonresponsive or steroid-intolerant severe alcohol-associated hepatitis: A pilot study - Adacyte<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.adacyte.com\/professional\/scientific-corner\/granulocyte-monocyte-macrophage-apheresis-for-steroid-nonresponsive-or-steroid-intolerant-severe-alcohol-associated-hepatitis-a-pilot-study\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Granulocyte-monocyte\/macrophage apheresis for steroid-nonresponsive or steroid-intolerant severe alcohol-associated hepatitis: A pilot study - Adacyte\" \/>\n<meta property=\"og:description\" content=\"Ryosuke Kasuga 1, Po-Sung Chu 1, Nobuhito Taniki 1, Aya Yoshida 1, Rei Morikawa 1, Takaya Tabuchi 1, Fumie Noguchi 1, Karin Yamataka 1, Yukie Nakadai 1, Mayuko Kondo 1, Hirotoshi Ebinuma 1 2, Takanori Kanai 1, Nobuhiro Nakamoto 1 Background: Patients with severe alcohol-associated hepatitis (SAH) have a high short-term mortality rate. 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