Nobuhiro Ueno 1, Yuya Sugiyama 1, Yu Kobayashi 1, Yuki Murakami 1, Takuya Iwama 2, Takahiro Sasaki 1, Takehito Kunogi 1, Aki Sakatani 1, Keitaro Takahashi 1, Kazuyuki Tanaka 3, Shinya Serikawa 4, Katsuyoshi Ando 1, Shin Kashima 1, Momotaro Muto 5, Yuhei Inaba 2, Kentaro Moriichi 1, Hiroki Tanabe 1, Toshikatsu Okumura 1, Mikihiro Fujiya
Concomitant pharmacologic medications influence the clinical outcomes of granulocyte and monocyte adsorptive apheresis in patients with ulcerative colitis: A multicenter retrospective cohort study
J Clin Apher. 2023 Jan 13. doi: 10.1002/jca.22040.
Background: Granulocyte and monocyte adsorptive apheresis (GMA) with Adacolumn has been used as a remission induction therapy for patients with active ulcerative colitis (UC). Herein, we investigated the influence of concomitant medications in the remission induction of GMA in patients with active UC. Methods: This multicenter retrospective cohort study included patients with UC underwent GMA in five independent institutions in Japan from January 2011 to July 2021. Factors including concomitant medications associated with clinical remission (CR) were analyzed statistically. Result: A total of 133 patients were included. Seventy-four patients achieved a CR after GMA. The multivariable analysis revealed that concomitant medication with 5-aminosalicylic acid, Mayo endoscopic subscore (MES), and concomitant medication with immunosuppressors (IMs) remained as predictors of CR after GMA. In the subgroup analysis in patients with MES of 2, concomitant medication with IMs was demonstrated as a significant negative factor of CR after GMA (P = .042, OR 0.354). Seventy-four patients who achieved CR after GMA were followed up for 52 weeks. In the multivariable analysis, the maintenance therapy with IMs was demonstrated as a significant positive factor of sustained CR up to 52 weeks (P = .038, OR 2.214). Furthermore, the rate of sustained CR in patients with biologics and IMs was significantly higher than that in patients with biologics only (P = .002). Conclusion: GMA was more effective for patients with active UC that relapsed under treatment without IMs. Furthermore, the addition of IMs should be considered in patients on maintenance therapy with biologics after GMA.
Concomitant pharmacologic medications influence the clinical outcomes of granulocyte and monocyte adsorptive apheresis in patients with ulcerative colitis: A multicenter retrospective cohort study – PubMed (nih.gov)
Chapter 53 – The use of therapeutic apheresis in allergic and immunological diseases
A Practical Guide to the Evaluation, Diagnosis and Management of Allergic and Immunologic Diseases 2022, Pages 1527-1583
Apheresis is a term for a group of extracorporeal treatments in which blood is separated into its components, with some components being discarded and replaced or subsequently modified. The replacement fluids/cells or modified components, along with the remainder of the blood, are then returned to the patient. These procedures can alter the immune system, both humoral and cellular, and have been used to treat a variety of common and uncommon immunologic diseases beginning in the late 1950s. The basic background information important for understanding those apheresis procedures used to treat immunologic disorders as well as the important patient considerations are discussed. A synopsis of immunologic diseases treated with apheresis, based upon the American Society for Apheresis Guidelines for the use of apheresis in clinical practice, is provided including treatment schedules and “dosing,” patient evaluation and laboratory monitoring, and the proposed mechanism of action. Unique considerations for each treatment, such as their effects on patient management and concurrent therapies, are also discussed. Apheresis is a group of related therapies that can effectively treat several immunologic diseases with a growing but still a limited base of published evidence.
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