title: Treatment of active steroid-refractory inflammatory bowel diseases with granulocytapheresis: Our experience with a prospective study.
abstract: OBJECTIVE
  To report our experience with the use of granulocytapheresis (GCAP) in 14 patients with active steroid-refractory inflammatory bowel disease (IBD) in order to evaluate its efficacy in achieving remission and maintaining a long lasting symptom-free period.
  
  
  METHODS
  The activity of the disease was evaluated by clinical activity index (CAI) and endoscopic index (EI) in ulcerative colitis (UC), while by Crohn's disease activity index (CDAI) in Crohn's disease (CD). The patients were treated using the Adacolumn system, an adsorption column which selectively binds to granulocytes and monocytes. One session/week of GCAP was performed for 5 wk. Steroids were stopped during apheresis.
  
  
  RESULTS
  All the patients completed the five-week course showing no complications. At the end of the last session, 93% of patients showed a clinical remission of the disease that persisted for 6 mo. Nine months after the end of the treatment, 60% of the cases maintained remission, while 23% of the patients were still in clinical remission after 12 mo.
  
  
  CONCLUSIONS
  Even if the number of our patients with steroid-refractory IBDs was not big, we can assert that GCAP is well tolerated and effective, especially in the first six months after the treatment, in a significant percentage of cases. The rate of sustained response drops slightly after 6 mo and significantly after 12 mo, however the absence of severe side effects can be a stimulus for further evaluating new schedules of treatment.
authors.affiliation: U.O. di Gastroenterologia, U.O. di Immunoematologia Azienda Ospedaliera-Universitaria Pisana, Pisa, Italy. gbresci @ libcro. it
authors.forename: Bresci
authors.initials: B
authors.lastname: Giampaolo
authors.forename: Parisi
authors.initials: P
authors.lastname: Giuseppe
authors.forename: Bertoni
authors.initials: B
authors.lastname: Michele
authors.forename: Mazzoni
authors.initials: M
authors.lastname: Alessandro
authors.forename: Scatena
authors.initials: S
authors.lastname: Fabrizio
authors.forename: Capria
authors.initials: C
authors.lastname: Alfonso
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006098:Granulocytes / Q000166:cytology*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D007937:Leukapheresis; D008297:Male; D011446:Prospective Studies
chemical_list: D000305:Adrenal Cortex Hormones