Scientific corner

Fecal Calprotectin is a Useful Biomarker for Predicting the Clinical Outcome of Granulocyte and Monocyte Adsorptive Apheresis in Ulcerative Colitis Patients: A Prospective Observation Study

Nobuhiro Ueno, Yuya Sugiyama, Yu Kobayashi, Yuki Murakami et al DOI:

In summary, we demonstrated the utility of FC as a biomarker for assessing ER after GMA and predicting CR at the early phase during GMA in patients with active UC. Assessing the baseline characteristics alone before GMA was not sufficient to predict CR. Our findings will benefit patients with active UC by allowing them to avoid undergoing unnecessary invasive procedures and will help establish new GMA therapeutic strategies.

Scientific corner

Exploratory Study of the Effectiveness of Granulocyte and Monocyte Adsorptive Apheresis Before Initiation of Steroids in Patients With Active Ulcerative Colitis (EXPECT Study): A Multicenter Prospective Clinical Trial

Scientific corner

Factors associated with the outcomes in ulcerative colitis patients undergoing granulocyte and monocyte adsorptive apheresis as remission induction therapy: A multicenter cohort study

Yoh Ishiguro 1Toshihide Ohmori 2Ken Umemura 3Masahiro Iizuka 4 ,Ther Apher Dial 2020 Oct 7.

GMA was an effective treatment for corticosteroid-naïve patients and the efficacy sustained longer in those not receiving immunomodulators during GMA. GMA fulfills the notion that apheresis is to induce disease remission by removing from the body factors known to perpetuate disease. In therapeutic settings, these findings should help better decision making and avoid futile use of medical resources.

Scientific corner

Adsorptive Depletion of Myeloid Lineage Leucocytes as Remission Induction Therapy in Patients with Ulcerative Colitis after Failure of First-Line Medications: Results from a Three-Year Real World, Clinical Practice

Takayuki Iida 1Kentaro IkeyaMasaichi KatoJinro AbeMasayoshi YamamotoFumitoshi WatanabeKen SugimotoHiroyuki Hanai , Digestion. 2017;96(2):119-126.

Corticosteroid-naïve patients appeared to benefit the most from the Adacolumn GMA, and attain a favourable long-term clinical course. Accordingly, GMA should be a first-line therapy in this clinical setting.

Scientific corner

Efficacy of granulocyte and monocyte apheresis for antibiotic-refractory pouchitis after proctocolectomy for ulcerative colitis: an open-label, prospective, multicentre study

Takayuki Yamamoto 1Toshiaki Tanaka 2Tadashi Yokoyama 3Takahiro Shimoyama 1Hiroki Ikeuchi 4Motoi Uchino 4Toshiaki Watanabe 5 , Therap Adv Gastroenterol. 2017 Feb;10(2):199-206.

GMA has a good safety profile, but its efficacy appears to be limited in the management of chronic refractory pouchitis. However, a large controlled study should be conducted to evaluate the efficacy of GMA therapy in patients with pouchitis at an earlier clinical stage, before the disease has become refractory to conventional medical therapy.

Scientific corner

Granulocyte-Monocyte Apheresis in Steroid-Dependent, Azathioprine-Intolerant/Resistant Moderate Ulcerative Colitis: A Prospective Multicenter Study.

Gianni Imperiali 1Arnaldo Amato 1Maria Maddalena Terpin 2Ivo Beverina 3Aurora Bortoli 4Massimo Devani 4Chiara Viganò 5,Gastroenterol Res Pract2017;2017:9728324.

Our study shows that a standard course of granulocyte-monocyte apheresis is associated with a 36% steroid-free clinical remission in patients with steroid-dependent, azathioprine-intolerant or resistant moderate ulcerative colitis. Apheresis might represent an alternative to biologic therapy or surgery in this specific subgroup of patients

Scientific corner

Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China.

Ya-Min Lai 1Wei-Yan Yao 2Yao He 3Xuan Jiang 4Yu-Bei Gu 2Min-Hu Chen 3Yu-Lan Liu 4Yao-Zong Yuan 2Jia-Ming Qian 1 , Gut Liver. 2017 Mar 15;11(2):216-225.

The overall efficacy of GMA in patients with active UC who were taking first-line medications or were corticosteroid refractory was encouraging. Additionally, GMA was well tolerated and had a good safety profile.

Scientific corner

Retrospective Single Center Study of Granulocyte Monocyte Adsorption Apheresis Treatment in Inflammatory Bowel Disease.

Kajsa Edfors 1Dagny Ståhlberg 1Charlotte Söderman 1 , Ther Apher Dial. 2016 Feb;20(1):79-85.

 Most frequently reported was headache (N = 4). GMA seems to be a valuable adjuvant treatment regime in the care of patients with refractory IBD.

Scientific corner

A randomised, double-blind, sham-controlled study of granulocyte/monocyte apheresis for moderate to severe Crohn’s disease.

Bruce E Sands 1Seymour KatzDouglas C WolfBrian G FeaganTao WangLisa-Marie GustofsonCindy WongMargaret K VandervoortStephen Hanauer, Gut. 2013 Sep;62(9):1288-94.

GMA was well tolerated, but this study did not demonstrate its effectiveness over a sham procedure in inducing clinical remission or response in patients with moderate to severe CD.

Scientific corner

Efficacy, safety and cost analyses in ulcerative colitis patients undergoing granulocyte and monocyte adsorption or receiving prednisolone.

Keiichi Tominaga 1Masakazu NakanoMina HoshinoKazunari KankeHideyuki Hiraishi, BMC Gastroenterol. 2013 Mar 1;13:41.

In appropriately selected patients, GMA has significant efficacy with no safety concern. The higher cost of GMA vs PSL should be compromised by good safety profile of this non-pharmacological treatment intervention.

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