Concomitant pharmacologic medications influence the clinical outcomes of granulocyte and monocyte adsorptive apheresis in patients with ulcerative colitis: A multicenter retrospective cohort study

Author:

Ueno Nobuhiro1ORCID,Sugiyama Yuya1,Kobayashi Yu1,Murakami Yuki1,Iwama Takuya2,Sasaki Takahiro1,Kunogi Takehito1,Sakatani Aki1,Takahashi Keitaro1,Tanaka Kazuyuki3,Serikawa Shinya4,Ando Katsuyoshi1,Kashima Shin1,Muto Momotaro5,Inaba Yuhei2,Moriichi Kentaro1,Tanabe Hiroki1,Okumura Toshikatsu1,Fujiya Mikihiro1

Affiliation:

1. Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine Asahikawa Medical University Asahikawa Hokkaido Japan

2. Asahikawa City Hospital Asahikawa Hokkaido Japan

3. Asahikawa Kosei General Hospital Asahikawa Hokkaido Japan

4. Nayoro City General Hospital Nayoro Hokkaido Japan

5. Engaru Kosei General Hospital Hokkaido Japan

Abstract

AbstractBackgroundGranulocyte and monocyte adsorptive apheresis (GMA) with Adacolumn has been used as a remission induction therapy for patients with active ulcerative colitis (UC). Herein, we investigated the influence of concomitant medications in the remission induction of GMA in patients with active UC.MethodsThis multicenter retrospective cohort study included patients with UC underwent GMA in five independent institutions in Japan from January 2011 to July 2021. Factors including concomitant medications associated with clinical remission (CR) were analyzed statistically.ResultA total of 133 patients were included. Seventy‐four patients achieved a CR after GMA. The multivariable analysis revealed that concomitant medication with 5‐aminosalicylic acid, Mayo endoscopic subscore (MES), and concomitant medication with immunosuppressors (IMs) remained as predictors of CR after GMA. In the subgroup analysis in patients with MES of 2, concomitant medication with IMs was demonstrated as a significant negative factor of CR after GMA (P = .042, OR 0.354). Seventy‐four patients who achieved CR after GMA were followed up for 52 weeks. In the multivariable analysis, the maintenance therapy with IMs was demonstrated as a significant positive factor of sustained CR up to 52 weeks (P = .038, OR 2.214). Furthermore, the rate of sustained CR in patients with biologics and IMs was significantly higher than that in patients with biologics only (P = .002).ConclusionGMA was more effective for patients with active UC that relapsed under treatment without IMs. Furthermore, the addition of IMs should be considered in patients on maintenance therapy with biologics after GMA.

Publisher

Wiley

Subject

Hematology,General Medicine

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