Granulocyteaphaeresis in steroid-dependent inflammatory bowel disease: a prospective, open, pilot study.
BACKGROUND
Uncontrolled studies suggest that granulocyteaphaeresis might be useful in the management of active ulcerative colitis.


OBJECTIVE
To assess the efficacy of granulocyteaphaeresis treatment in active steroid-dependent inflammatory bowel disease.


METHODS
We conducted a multicentre, prospective, open, pilot study in patients with steroid-dependent inflammatory bowel disease. All patients were started on 60 mg/day of prednisone; after 1 week, a five-session programme of granulocyteaphaeresis (once per week) was started. The steroid dose was tapered weekly if there was clinical improvement. Remission was defined as an inactive clinical activity index together with complete withdrawal of steroids at week 6. The patients were followed up for at least 6 months or until disease relapse.


RESULTS
Twenty-six patients (14 ulcerative colitis, 12 Crohn's disease) were included. More than a half had been previously treated with immunomodulators. Remission was achieved in 62 and 70% of ulcerative colitis and Crohn's disease, respectively. During a median follow-up of 12.6 months, six of eight ulcerative colitis patients maintained their clinical remission; however, only one Crohn's disease patient remained in remission after the first 6 months of follow-up.


CONCLUSIONS
Granulocyteaphaeresis is a safe treatment option in inflammatory bowel disease. A five-session programme of granulocyteaphaeresis seems to be efficient in the treatment of steroid-dependent ulcerative colitis, but not in Crohn's disease.
Domènech
E
E
Hospital Universitari Germans Trias i Pujol, Badalona, Spain. domenech@ns.hugtip.scs.es
Hinojosa
J
J
Esteve-Comas
M
M
Gomollón
F
F
Herrera
J M
JM
Bastida
G
G
Obrador
A
A
Ruiz
R
R
Saro
C
C
Gassull
M A
MA
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000628:therapy*; D003424:Crohn Disease / Q000628:therapy*; D005260:Female; D006098:Granulocytes; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D008297:Male; D010865:Pilot Projects; D011239:Prednisolone / Q000627:therapeutic use*; D011446:Prospective Studies; D012074:Remission Induction
D000893:Anti-Inflammatory Agents; D011239:Prednisolone