title: Granulocyte-Monocyte Apheresis as an Adjuvant Therapy to Anti-Tumor Necrosis Factor Drugs for Ulcerative Colitis.
abstract: Biologic anti-tumor necrosis factor (TNF) drugs have demonstrated their efficacy for the treatment of ulcerative colitis. Nevertheless, some patients will not respond to this therapy or will develop loss of response. Leukapheresis is the main non-pharmacological therapy for some immune-mediated diseases. The aim of our study was to describe our experience with this therapy in ulcerative colitis patients after loss of response to anti-TNF treatment. Leukapheresis was indicated in four patients with left-sided or extensive colitis because of partial response to biological therapy or secondary loss of response to it. All patients received 8 to 10 sessions in an intensive regimen. Globally, a decrease in the Mayo score was observed. The overall response rate was 50% with one patient who displayed sustained response. No patients have required colectomy during follow-up. Adjuvant treatment with leukapheresis in patients with inadequate response to anti-TNF treatment showed some beneficial effect, although of limited duration, in patients with ulcerative colitis.
authors.affiliation: Gastroenterology Department, Hospital de Galdakao, Galdakao, Vizcaya, Spain.
authors.forename: Iago
authors.identifier: http://orcid.org/0000-0003-1133-4578
authors.initials: I
authors.lastname: Rodríguez-Lago
authors.affiliation: Gastroenterology Department, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Gómez-Irwin
authors.affiliation: Dialysis Unit, Nephrology Department, Hospital de Galdakao, Galdakao, Vizcaya, Spain.
authors.forename: Encarnación
authors.initials: E
authors.lastname: Fernández
authors.affiliation: Gastroenterology Department, Hospital de San Eloy, Baracaldo, Vizcaya, Spain.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Higuera
authors.affiliation: Gastroenterology Department, Hospital de Galdakao, Galdakao, Vizcaya, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Cabriada
mesh_terms: D000328:Adult; D001781:Blood Component Removal / Q000379:methods*; D003093:Colitis, Ulcerative / Q000628:therapy*; D003131:Combined Modality Therapy; D006098:Granulocytes; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D012189:Retrospective Studies; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D014409:Tumor Necrosis Factor-alpha
keywords: Anti-tumor necrosis factor; Biologic drug; Inflammatory bowel disease; Leukocytapheresis; Ulcerative colitis