Comparison of early versus late addition of granulocyte and monocyte adsorption for incomplete remission induction in ulcerative colitis

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY
JGH Open Pub Date : 2024-07-24 DOI:10.1002/jgh3.70012
Keiichi Tominaga, Mimari Kanazawa, Shoko Watanabe, Takanao Tanaka, Shunsuke Kojimahara, Satoshi Masuyama, Keiichiro Abe, Akira Kanamori, Akira Yamamiya, Takeshi Sugaya, Kenichi Goda, Yuji Fujita, Shigemi Yoshihara, Yasuo Haruyama, Atsushi Irisawa
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Abstract

Background and aim

Ulcerative colitis (UC) is characterized by repeated relapse and remission. Because no fundamental therapeutic strategy has been established, the treatment goal is generally to maintain the remission phase for a long period after rapid remission induction. Granulocyte and monocyte adsorption (GMA) for UC is reportedly quite safe because it does not affect immunosuppression. Moreover, it is useful in combination with other remission induction therapy. The aim of this study was to evaluate the difference in efficacy by the timing of the addition of GMA with corticosteroids, calcineurin inhibitors, and anti-cytokine therapy for active UC.

Methods

The study included 59 patients. Patients who started GMA of 5–11 days were in the early GMA combination group. Patients who started GMA 12 days or more were in the late GMA combination group. The primary endpoint was difference in the effect of additional GMA according to the timing of the intervention. The secondary endpoint was difference in the time to remission induction between the two groups.

Results

Of the 32 early GMA group patients, 24 achieved remission induction. Of the 27 late group patients, 18 achieved remission induction. No significant difference in induction rates was found (P = 0.481). The early group had shorter mean time to remission induction (P < 0.001).

Conclusions

In conclusion, results suggest that early addition of GMA might lead to earlier remission in patients who have had an inadequate response to remission induction therapy with corticosteroids, calcineurin inhibitors, and anti-cytokine therapy.

Abstract Image

在溃疡性结肠炎不完全缓解诱导中,早期与晚期加入粒细胞和单核细胞吸附的比较。
背景和目的:溃疡性结肠炎(UC)的特点是反复复发和缓解。由于尚未确立根本的治疗策略,治疗目标通常是在快速诱导缓解后长期维持缓解期。据报道,粒细胞和单核细胞吸附(GMA)治疗 UC 相当安全,因为它不会影响免疫抑制。此外,它还可与其他缓解诱导疗法联合使用。本研究的目的是评估在皮质类固醇激素、钙调磷酸酶抑制剂和抗细胞因子治疗活动性 UC 的同时添加 GMA 在疗效上的差异:研究纳入了 59 名患者。开始 GMA 5-11 天的患者为早期 GMA 联合治疗组。开始 GMA 12 天或更长时间的患者为晚期 GMA 联合治疗组。主要终点是根据干预时间的不同,额外 GMA 效果的差异。次要终点是两组患者获得缓解的时间差异:在 32 名早期 GMA 组患者中,有 24 人获得了缓解。在 27 名晚期组患者中,有 18 人获得了缓解诱导。两组诱导率无明显差异(P=0.481)。早期组患者获得缓解诱导的平均时间较短(P 结论:早期组患者获得缓解诱导的平均时间较短,而晚期组患者获得缓解诱导的平均时间较长:总之,研究结果表明,对于使用皮质类固醇、钙调磷酸酶抑制剂和抗细胞因子治疗后缓解诱导反应不充分的患者,早期添加 GMA 可使病情更早缓解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JGH Open
JGH Open GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
3.40
自引率
0.00%
发文量
143
审稿时长
7 weeks
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