Adsorptive Granulocyte and Monocyte Apheresis versus Prednisolone in Patients with Corticosteroid-Dependent Moderately Severe Ulcerative ColitisHanai H.a · Watanabe F.b · Yamada M.c · Sato Y.d · Takeuchi K.a · Iida T.a · Tozawa K.a · Tanaka T.a · Maruyama Y.b · Matsushita I.d · Iwaoka Y.c · Kikuch K.e · Saniabadi A.R.f
aDepartment of Medicine, Hamamatsu University; bFujueda General Hospital; cHamamatsu Medical Centre; dSeirei General Hospital, Hamamatsu; eNational Tosei Hospital, Nagaizumi, and fJapan Immunoresearch Laboratories, Takasaki, Japan
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Background/Aim: Active ulcerative colitis (UC) is often associated with increased peripheral granulocytes and monocytes/macrophages which show activation behavior and prolonged survival time. Further, mucosal granulocyte level parallels intestinal inflammation and can predict UC relapse. Accordingly, our aim was to see if adsorptive granulocyte/monocyte apheresis (GMA) can promote remission and spare steroid in patients with steroid-dependent (SD) UC. Methods: 69 SD patients, at the time of relapse, were randomly assigned to groups I (n = 46) and II (n = 23). The mean dose of prednisolone (PSL) was 12 mg/day/patient, CAI (clinical activity index) 9.2 in both groups. Group I patients were given up to 11 GMA sessions over 10 weeks with Adacolumn; in group II, the mean dose of PSL was increased to 30 mg/day/patient. Results: At week 12, 83% of group I and 65% of group II patients were in remission, CAI in group I was 1.7 (p < 0.001) and in group II, 2.5 (p < 0.001). Further, during the 12 weeks of treatment, the cumulative amount of PSL received per patient was 1,157 mg in group I and 1,938 mg in group II (p = 0.001). Conclusions: GMA appeared to be an effective adjunct to standard drug therapy of moderately severe UC by promoting remission and sparing steroids.
© 2004 S. Karger AG, Basel
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