title: Efficacy and safety of granulocyte and monocyte adsorption apheresis for ulcerative colitis: a meta-analysis.
abstract: BACKGROUND
  Safe and effective treatments are required for patients with ulcerative colitis. It was suggested that granulocyte and monocyte adsorption apheresis might play an important role for ulcerative colitis. Therefore, a meta-analysis was performed.
  
  
  METHODS
  Medline and the Cochrane controlled trials register were used to identify randomized controlled trials comparing granulocyte and monocyte adsorption apheresis with corticosteroids, and comparing intensive with conventional apheresis in patients with ulcerative colitis.
  
  
  RESULTS
  Nine randomized trials were eligible for inclusion criteria. According to pooled data, granulocyte and monocyte adsorption apheresis is effective for inducing clinical remission in patients with ulcerative colitis compared with corticosteroids (odds ratio, 2.23; 95% confidence interval: 1.38-3.60). However, the efficacy of granulocyte and monocyte adsorption apheresis was not dependent on the number of apheresis sessions. The intensive apheresis (≥2 sessions per week) is more effective for inducing clinical remission than weekly apheresis (odds ratio, 2.10; 95% confidence interval: 1.12-3.93). The rate of adverse events by apheresis was significantly lower than that by corticosteroids (odds ratio, 0.24; 95% confidence interval: 0.15-0.37).
  
  
  CONCLUSIONS
  Our meta-analysis reveals that intensive granulocyte and monocyte adsorption apheresis is a safe and effective treatment with higher rates of clinical remission and response for ulcerative colitis compared with corticosteroids.
authors.affiliation: Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University, Japan; Division of Gastroenterology & Hepatology, Digestive Disease Center, Kitano Hospital, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Yoshino
authors.affiliation: Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University, Japan. Electronic address: hiropy_n@kuhp.kyoto-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakase
authors.affiliation: Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Minami
authors.affiliation: Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Matsuura
authors.affiliation: Division of Gastroenterology & Hepatology, Digestive Disease Center, Kitano Hospital, Japan.
authors.forename: Shujiro
authors.initials: S
authors.lastname: Yazumi
authors.affiliation: Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Chiba
mesh_terms: D000327:Adsorption; D003093:Colitis, Ulcerative / Q000628:therapy*; D005938:Glucocorticoids / Q000627:therapeutic use; D006098:Granulocytes; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D009000:Monocytes; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction / Q000379:methods; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids
keywords: Corticosteroids; Granulocyte and monocyte adsorption apheresis; Ulcerative colitis