Efficacy of cytapheresis for induction therapy and extra-intestinal skin manifestations of ulcerative colitis
Introduction: In recent years, the prevalence of inflammatory bowel diseases has been increasing in Japan due to the westernization of lifestyles. Many patients have been reported to have extra-intestinal manifestations (EIMs) at least once. Skin lesions occur with a high degree of frequency among EIMs, with erythema nodosum (EN) and pyoderma gangrenosum (PG) the main complications. Cytapheresis is again attracting attention as a treatment with few side effects. Methods: We investigated the therapeutic effect of cytapheresis on ulcerative colitis (UC) and cutaneous EIMs. Between 2008 and 2021, 240 patients with active UC had induction therapy by cytapheresis at our hospital. Results: Remission and response rates were 50.0% and 67.5%, respectively. Apheresis was performed on seven patients with PG and five patients with EN with a good response. Serious adverse events were not observed. Conclusion: This retrospective assessment of efficacy showed that EN and PG responded favorably to cytapheresis.
Adsorptive Granulocyte and Monocyte Apheresis Is Effective in Ulcerative Colitis Patients Both with and without Concomitant Prednisolone
Keiji Matsuda 1 2, Kohei Ohno 1, Yuka Okada 1, Takahiro Yagi 1, Mitsuo Tsukamoto 1, Yoshihisa Fukushima 1, Atsushi Horiuchi 1, Ryu Shimada 1 2, Tsuyoshi Ozawa 1 2, Tamuro Hayama 1 2, Takeshi Tsuchiya 1 2, Junko Tamura 1, Hisae Iinuma 1, Keijiro Nozawa 1 2, Hitoshi Aoyagi 2 3, Akari Isono 2 3, Koichiro Abe 2 3, Shinya Kodashima 2 3, Takatsugu Yamamoto 2 3, Yoshitaka Kawasaki 4, Yoshifuru Tamura 4, Yuko Sasajima 5, Fukuo Kondo 5, Yojiro Hashiguchi 1 2 , Inflamm Intest Dis, 2020 Feb;5(1):36-41.
The effect of GMA with concomitant PSL (Prednisolone) and that of GMA without PSL were not different, and GMA was effective irrespective of PSL administration. The present study showed that GMA had efficacy and led many UC patients treated by PSL to be steroid free with no safety concern in the real world, although there is the possibility of recruitment bias due to the retrospective nature of the study.
Retrospective Single Center Study of Granulocyte Monocyte Adsorption Apheresis Treatment in Inflammatory Bowel Disease.
Most frequently reported was headache (N = 4). GMA seems to be a valuable adjuvant treatment regime in the care of patients with refractory IBD.
Cytapheresis in patients with severe ulcerative colitis after failure of intravenous corticosteroid: a long-term retrospective cohort study
Ken Fukunaga 1, Kazuko Nagase, Takeshi Kusaka, Nobuyuki Hida, Yoshio Ohda, Koji Yoshida, Katsuyuki Tozawa, Koji Kamikozuru, M Iimuro, Shiro Nakamura, Hiroto Miwa, Takayuki Matsumoto, Gut Liver. 2009 Mar;3(1):41-7. doi: 10.5009/gnl.2009.3.1.41
This study suggest that CAP is an effective therapy in patients who are refractory to conventional medications including iv corticosteroid. Increased remission rates should be expected in refractory patients with moderately severe UC.
A retrospective search for predictors of clinical response to selective granulocyte and monocyte apheresis in patients with ulcerative colitis
Recently, selective granulocytapheresis (Adacolumn) has appeared as a new treatment for patients with inflammatory bowel disease. This study sought to determine predictors of response to this new nonpharmacologic mode of therapy by retrospectively evaluating 28 patients who received granulocytapheresis after experiencing active ulcerative colitis (UC). Between April 2000 and March 2004, 28 consecutive patients received granulocytapheresis for active UC with the Adacolumn, which is filled with cellulose acetate beads as the column leukocytapheresis carriers; the carriers adsorb granulocytes, monocytes/macrophages, and a small fraction of lymphocytes (FcgammaR and complement receptors bearing leukocytes). Each patient could receive up to 10 Adacolumn sessions, at 2 sessions per week. In 2004, clinical response was retrospectively evaluated. Seven days after the last Adacolumn session, 20 of 28 patients had remission (colitis activity index [CAI] < or =4) including all 8 patients who had their first UC episode. The mean duration of UC in the 8 first episode cases was 3.4 months compared with 40.2 months for all 28 patients and 65.4 months for the 8 nonresponders. The response to Adacolumn was independent of basal CAI. The 8 nonresponders were given conventional medication (CM) or cyclosporine (CsA) if the former failed. Two responded to CM, 3 to CsA, and 3 underwent colectomy. First UC episode and short disease duration appear good predictors of response to granulocytapheresis. Selective granulocytapheresis might be an effective first-line treatment.
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