Can Adacolumn® be used in combination with other drugs for maintaining remission in IBD?

Dra. Pilar Nos

Apheresis has been used for this and in fact there have been reviews that suggest that using it as a bridge could be a good scenario, for example, as a bridge to maintenance with vedolizumab, with an integrin, this has been suggested. It has also been suggested that it may be used initially in combination and then one of the two mechanisms can be removed. What is true is that we are in absolute scientific limbo because here our experiences are from observational series and it is also very difficult to have factors that predict the response. We don’t have a crystal ball to tell us which patients are going to benefit from the combination, in which patients you have to remove one of the drugs. If we don’t know for things as widespread as an anti-TNF and an immunosuppressant, then we’re in a position where individualisation is all we can do.

References:

• Yoko Yokoyama, Koji Sawada, Nobuo Aoyama, et al:  Efficacy of Granulocyte and Monocyte Adsorptive Apheresis in Patients With Inflammatory Bowel Disease Showing Lost Response to Infliximab, Journal of Crohn’s and Colitis 2020,1-10.
• Rodríguez-Lago I, et al.: Granulocyte-monocyte apheresis: an alternative combination therapy after Loss of response to anti-TNF agents in ulcerative colitis? Scand J Gastro 2019 Apr;54(4):459-464.
• Iizuka M, Etou T, Sagara S. Efficacy of cytapheresis in patients with ulcerative colitis showing insufficient or lost response to biologic therapy. World J Gastroenterol. 2022 Sep 14;28(34):4959-4972.
• Bamias G, Zampeli E, Domènech E. Targeting neutrophils in inflammatory bowel disease: revisiting the role of adsorptive granulocyte and monocyte apheresis. Expert Rev Gastroenterol Hepatol. 2022 Aug;16(8):721-735.
• Domènech, E., et al Use of granulocyte/monocytapheresis in ulcerative colitis: A practical review from a European perspective. World journal of gastroenterology, 2021; 27(10), 908–918.