An Open-Label Prospective Randomized Multicenter Study Shows Very Rapid Remission of Ulcerative Colitis by Intensive Granulocyte and Monocyte Adsorptive Apheresis ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-09-01

AUTHORS

Atsushi Sakuraba, Satoshi Motoya, Kenji Watanabe, Masakazu Nishishita, Kazunari Kanke, Toshiyuki Matsui, Yasuo Suzuki, Tadayuki Oshima, Reiko Kunisaki, Takayuki Matsumoto, Hiroyuki Hanai, Ken Fukunaga, Naoki Yoshimura, Toshimi Chiba, Shinsuke Funakoshi, Nobuo Aoyama, Akira Andoh, Hiroshi Nakase, Yohei Mizuta, Ryoichi Suzuki, Taiji Akamatsu, Masahiro Iizuka, Toshifumi Ashida, Toshifumi Hibi

ABSTRACT

OBJECTIVES: Granulocyte and monocyte adsorptive apheresis (GMA) has shown efficacy in patients with active ulcerative colitis (UC). However, with routine weekly treatment, it may take several weeks to achieve remission, and to date, the efficacy of a more frequent treatment schedule remains unknown. The aim of this study was to assess the clinical efficacy and safety of intensive GMA treatment in patients with active UC. METHODS: This was an open-label, prospective, randomized multicenter study to compare an intensive, two GMA sessions per week, with the routine, one GMA session per week. A total of 163 patients with mild-to-moderately active UC were randomly assigned to routine weekly treatment or intensive treatment. The maximum number of sessions of GMA permitted was 10. However, when patients achieved remission, GMA was discontinued. Remission rate at the end of the study, time to remission, and adverse events were assessed in both groups. RESULTS: Of the 163 patients, 149 were available for efficacy analysis as per protocol, 76 were in weekly GMA, and 73 were in intensive GMA. At the end of the study period, clinical remission was achieved in 41 of 76 patients (54.0%) in weekly GMA and in 52 of 73 patients (71.2%) in intensive GMA (P=0.029). The mean time to remission was 28.1+/-16.9 days in the weekly GMA treatment group and 14.9+/-9.5 days in the intensive GMA group (P<0.0001). Intensive GMA was well tolerated without GMA-related serious adverse side effects. CONCLUSIONS: Intensive GMA in patients with active UC seems to be more efficacious than weekly treatment, and significantly reduced the patients' morbidity time without increasing the incidence of side effects. More... »

PAGES

ajg2009453

Journal

TITLE

The American Journal of Gastroenterology

ISSUE

12

VOLUME

104

Author Affiliations

  • Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
  • Department of Gastroenterology, Sapporo Kosei General Hospital, Sapporo, Japan
  • Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Nishishita Intestinal Hospital, Osaka, Japan
  • Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
  • Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
  • Department of Internal Medicine, Sakura Hospital, Toho University, Sakura, Japan
  • Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
  • Department of Internal Medicine, Kyusyu University, Fukuoka, Japan
  • Kakegawa North Hospital, Kakegawa, Japan
  • Department of Gastroenterology, Hyogo College of Medicine, Hyougo, Japan
  • Department of Internal Medicine, Chiba University, Chiba, Japan
  • The First Department of Internal Medicine, Iwate Medical University School of Medicine, Masoka, Japan
  • Department of Internal Medicine, Kitasato Institute Hospital, Tokyo, Japan
  • Department of Endoscopy, Kobe University School of Medicine, Kobe, Japan
  • Division of Gastroenterology, Shiga University of Medical Science, Otsu, Japan
  • Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  • Department of Internal Medicine, Nagasaki University, Nagasaki, Japan
  • Kannai Suzuki Clinic, Yokohama, Japan
  • Division of Gastroenterology, The Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
  • The First Department of Internal Medicine, Akita University School of Medicine, Akita, Japan
  • The Third Department of Internal Medicine, Asahikawa Medical College, Asahikawa, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/ajg.2009.453

    DOI

    http://dx.doi.org/10.1038/ajg.2009.453

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1014082600

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/19724269


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