A pilot open-labeled prospective randomized study between weekly and intensive treatment of granulocyte and monocyte adsorption apheresis for active ulcerative colitis.
BACKGROUND
Recently, granulocyte and monocyte adsorption apheresis (GMA) has been shown to be effective for active ulcerative colitis (UC). Its original weekly treatment schedule is effective in about 70% of active UC. However, it takes about 3-4 weeks to achieve remission, and the efficacy of a more frequent treatment schedule has not been elucidated yet. We performed a pilot open-labeled prospective, randomized, controlled study comparing weekly and an intensive treatment schedule with three treatment sessions per week in the first 2 weeks.


METHODS
Thirty active UC patients with moderate disease activity were prospectively and randomly assigned to receive the original or the intensive treatment schedule for a total of ten sessions. The proportion of the patients achieving remission and the time to achieve remission among them was compared between the two groups. The incidences of adverse effects were also compared between the two groups.


RESULTS
The rate of inducing remission in the original and intensive treatment group was 66.7% and 80%, respectively (P = 0.25, NS). The time to achieve remission was 27.2 days in the original group and 10.7 days in the intensive group (P = 0.04). Adverse effects were observed in two patients in each groups (NS).


CONCLUSIONS
Intensive treatment with GMA is an efficacious and safe treatment for active UC. Because it induces rapid remission, it may be a more ideal treatment regimen than the conventional weekly treatment.
Sakuraba
Atsushi
A
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku,Tokyo, 160-8582, Japan.
Sato
Toshiro
T
Naganuma
Makoto
M
Morohoshi
Yuichi
Y
Matsuoka
Katsuyoshi
K
Inoue
Nagamu
N
Takaishi
Hiromasa
H
Ogata
Haruhiko
H
Iwao
Yasushi
Y
Hibi
Toshifumi
T
D000327:Adsorption; D000328:Adult; D003093:Colitis, Ulcerative / Q000097:blood / Q000473:pathology / Q000628:therapy*; D003113:Colonoscopy; D003422:Critical Care / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006098:Granulocytes; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D007958:Leukocyte Count; D008297:Male; D009000:Monocytes; D010865:Pilot Projects; D011446:Prospective Studies; D012074:Remission Induction / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome