METHODS: A retrospective study was performed in 12 IBD Units, including all patients with refractory UC or unclassified IBD (IBD-U) who received combined GMA plus UST. The number and frequency of GMA sessions, filtered blood volume and time of each session were registered. Efficacy was assessed 1 and 6 months after finishing GMA by partial Mayo score, C-reactive protein (CRP) and fecal calprotectin (FC). Descriptive statistics and non-parametric tests were used in the statistical analysis.
RESULTS: Seventeen patients were included (15 UC, 2 IBD-U; median age 47 years [IQR, 35-61]; 59% male; 53% E3). Most patients (89%) had prior exposure to anti-TNF agents and 53% to vedolizumab; 65% were also receiving steroids at baseline. Median partial Mayo score at baseline was 6 (IQR, 5-7) and it significantly decreased after 1 and 6 months (p=0.042 and 0.007, respectively). Baseline FC significantly decreased after 6 months (p=0.028) while no differences were found in CRP. During follow-up, 18% patients started a new biologic therapy and 12% required surgery; 64% of patients under steroids were able to discontinue them. Adverse events were reported in one patient.
CONCLUSIONS: GMA can recapture the response to UST in selected cases of UC after PNR or LOR to this drug.
方法:对12个IBD单位进行了回顾性研究,包括接受GMA+UST联合治疗的所有难治性UC或未分类IBD(IBD-U)患者。GMA会议的数量和频率,记录每个疗程的过滤血容量和时间.通过部分Mayo评分在完成GMA后1个月和6个月评估疗效,C反应蛋白(CRP)和粪便钙卫蛋白(FC)。统计分析采用描述性统计和非参数检验。
结果:纳入17例患者(15例UC,2IBD-U;平均年龄47岁[IQR,35-61];59%男性;53%E3)。大多数患者(89%)先前曾暴露于抗TNF药物,53%接受维多珠单抗;65%也在基线接受类固醇治疗。基线时部分Mayo评分中位数为6(IQR,5-7),并且在1个月和6个月后显着降低(分别为p=0.042和0.007)。6个月后,基线FC显着降低(p=0.028),而CRP无差异。随访期间,18%的患者开始了新的生物治疗,12%的患者需要手术;64%的患者使用类固醇能够停止他们。在一名患者中报告了不良事件。
结论:在PNR或LOR后,GMA可以在某些UC病例中重新获得对UST的反应。