Comparison of early versus late addition of granulocyte and monocyte adsorption for incomplete remission induction in ulcerative colitis.

Autor: Tominaga K; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Kanazawa M; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Watanabe S; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Tanaka T; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Kojimahara S; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Masuyama S; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Abe K; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Kanamori A; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Yamamiya A; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Sugaya T; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Goda K; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan., Fujita Y; Department of Pediatrics Dokkyo Medical University School of Medicine Tochigi Japan., Yoshihara S; Department of Pediatrics Dokkyo Medical University School of Medicine Tochigi Japan., Haruyama Y; Integrated Research Faculty for Advanced Medical Sciences Dokkyo Medical University Tochigi Japan., Irisawa A; Department of Gastroenterology Dokkyo Medical University School of Medicine Tochigi Japan.
Jazyk: angličtina
Zdroj: JGH open : an open access journal of gastroenterology and hepatology [JGH Open] 2024 Jul 24; Vol. 8 (7), pp. e70012. Date of Electronic Publication: 2024 Jul 24 (Print Publication: 2024).
DOI: 10.1002/jgh3.70012
Abstrakt: Background and Aim: Ulcerative colitis (UC) is characterized by repeated relapse and remission. Because no fundamental therapeutic strategy has been established, the treatment goal is generally to maintain the remission phase for a long period after rapid remission induction. Granulocyte and monocyte adsorption (GMA) for UC is reportedly quite safe because it does not affect immunosuppression. Moreover, it is useful in combination with other remission induction therapy. The aim of this study was to evaluate the difference in efficacy by the timing of the addition of GMA with corticosteroids, calcineurin inhibitors, and anti-cytokine therapy for active UC.
Methods: The study included 59 patients. Patients who started GMA of 5-11 days were in the early GMA combination group. Patients who started GMA 12 days or more were in the late GMA combination group. The primary endpoint was difference in the effect of additional GMA according to the timing of the intervention. The secondary endpoint was difference in the time to remission induction between the two groups.
Results: Of the 32 early GMA group patients, 24 achieved remission induction. Of the 27 late group patients, 18 achieved remission induction. No significant difference in induction rates was found ( P  = 0.481). The early group had shorter mean time to remission induction ( P  < 0.001).
Conclusions: In conclusion, results suggest that early addition of GMA might lead to earlier remission in patients who have had an inadequate response to remission induction therapy with corticosteroids, calcineurin inhibitors, and anti-cytokine therapy.
(© 2024 The Author(s). JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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