Scientific corner

Efficacy and safety of granulocyte adsorption apheresis in elderly patients with ulcerative colitis.

Ayumi Ito 1Teppei Omori 1Norio Hanafusa 1Ken Tsuchiya 1Shinichi Nakamura 1Katsutoshi Tokushige 1 , J Clin Apher. 2018 Aug;33(4):514-520.

Background: Elderly ulcerative colitis (UC) is increasing. Elderly UC differ from younger UC with respect to the course of their disease. Granulocyte adsorption apheresis (CAP) is often used to treat elderly UC. We retrospectively analyzed the cases of elderly UC who underwent CAP for remission induction therapy in a comparison with younger UC. Methods: 96 patients with UC underwent CAP. Patients who concurrently received tacrolimus, biological agents, or high-dose steroid therapy were excluded. The remaining 80 patients were evaluated. We divided them into an elderly group (aged ≥65 years) and a younger group, and then we compared the groups’ (1) clinical characteristics, (2) the efficacy and adverse effects of CAP, and (3) the complications of PSL. Results: The remission rate was 70.8% in the elderly group and 87.5% in the younger group. There were significant differences between the two groups with respect to the age at the onset of UC, the estimated glomerular filtration rate on admission, underlying diseases, and complications of PSL therapy. Adverse effects of CAP included headache, complications of blood reinfusion, heparin allergy, hypotension, and failure of blood removal. There were significant differences between the two groups with respect to the complications of PSL therapy (all P < .05). Conclusions: Although the elderly group had longer durations of UC, a higher prevalence of underlying diseases, and a higher frequency of adverse events due to PSL therapy, no serious adverse effects of CAP occurred in either group. Thus, CAP was safe and effective in both younger and elderly UC.

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