Abstract：
BACKGROUND: Granulocyte and monocyte adsorptive apheresis (GMA) removes neutrophils and monocytes from peripheral blood, preventing their incorporation into the inflamed tissue also influencing cytokine balance. Published therapeutic efficacy in ulcerative colitis (UC) is more consistent than in Crohn\'s disease (CD). We assessed clinical efficacy of GMA in UC and CD 4 weeks after last induction session, at 3 and 12 months, sustained remission and corticosteroid-free remission.
METHODS: Retrospective observational study of UC and CD patients treated with GMA. Partial Disease Activity Index-DAIp in UC and Harvey-Bradshaw Index-HBI in CD assessed efficacy of Adacolumn® with induction and optional maintenance sessions.
RESULTS: We treated 87 patients (CD-25, UC-62), 87.3% corticosteroid-dependent (CSD), 42.5% refractory/intolerant to immunomodulators. In UC, remission and response were 32.2% and 19.3% after induction, 35.5% and 6.5% at 12 weeks and 29% and 6.5% at 52 weeks. In CD, remission rates were 60%, 52% and 40% respectively. In corticosteroid-dependent and refractory or intolerant to INM patients (UC-41, CD-14), 68.3% of UC achieved remission or response after induction, 51.2% at 12 weeks and 46.3% at 52 weeks, and 62.3%, 64.3% and 42.9% in CD. Maintained remission was achieved by 66.6% in CD and 53.1% in UC. Up to 74.5% of patients required corticosteroids at some timepoint. Corticosteroid-free response/remission was 17.7% in UC and 24% in CD.
CONCLUSIONS: GMA is a good therapeutic tool for both in UC and CD patients. In corticosteroid-dependent and refractory or intolerant to INM patients it avoids biological therapy or surgery in up to 40% of them in one year.
METHODS: Retrospective observational study of UC and CD patients treated with GMA. Partial Disease Activity Index-DAIp in UC and Harvey-Bradshaw Index-HBI in CD assessed efficacy of Adacolumn® with induction and optional maintenance sessions.
RESULTS: We treated 87 patients (CD-25, UC-62), 87.3% corticosteroid-dependent (CSD), 42.5% refractory/intolerant to immunomodulators. In UC, remission and response were 32.2% and 19.3% after induction, 35.5% and 6.5% at 12 weeks and 29% and 6.5% at 52 weeks. In CD, remission rates were 60%, 52% and 40% respectively. In corticosteroid-dependent and refractory or intolerant to INM patients (UC-41, CD-14), 68.3% of UC achieved remission or response after induction, 51.2% at 12 weeks and 46.3% at 52 weeks, and 62.3%, 64.3% and 42.9% in CD. Maintained remission was achieved by 66.6% in CD and 53.1% in UC. Up to 74.5% of patients required corticosteroids at some timepoint. Corticosteroid-free response/remission was 17.7% in UC and 24% in CD.
CONCLUSIONS: GMA is a good therapeutic tool for both in UC and CD patients. In corticosteroid-dependent and refractory or intolerant to INM patients it avoids biological therapy or surgery in up to 40% of them in one year.
摘要：
背景：粒细胞和单核细胞吸附分离术（GMA）从外周血中去除中性粒细胞和单核细胞，防止它们掺入发炎组织也影响细胞因子平衡。在溃疡性结肠炎（UC）中发表的治疗效果比在克罗恩氏病（CD）中更为一致。我们在最后一次诱导后4周评估了GMA在UC和CD中的临床疗效，在3个月和12个月时，持续缓解和无皮质类固醇缓解。
方法：对接受GMA治疗的UC和CD患者进行回顾性观察研究。UC中的部分疾病活动指数-DAIp和CD中的Harvey-Bradshaw指数-HBI评估了Adacolumn®的诱导和可选的维持疗程的功效。
结果：我们治疗了87例患者（CD-25，UC-62），87.3％皮质类固醇依赖性（CSD），42.5%对免疫调节剂难治/不耐受。在UC,诱导后缓解和反应分别为32.2%和19.3%，12周时为35.5%和6.5%，52周时为29%和6.5%。在CD中,缓解率为60%,分别为52%和40%。在对INM患者（UC-41，CD-14）的皮质类固醇依赖性和难治性或不耐受中，68.3％的UC在诱导后达到缓解或反应，12周时51.2%,52周时46.3%,和62.3%，CD中的64.3%和42.9%。CD和UC的缓解率分别为66.6%和53.1%。高达74.5%的患者在某个时间点需要皮质类固醇。无皮质类固醇反应/缓解在UC中为17.7％，在CD中为24％。
结论：GMA是UC和CD患者的良好治疗工具。在皮质类固醇依赖性和难治性或不耐受的INM患者中，一年内高达40％的患者避免了生物治疗或手术。
方法：对接受GMA治疗的UC和CD患者进行回顾性观察研究。UC中的部分疾病活动指数-DAIp和CD中的Harvey-Bradshaw指数-HBI评估了Adacolumn®的诱导和可选的维持疗程的功效。
结果：我们治疗了87例患者（CD-25，UC-62），87.3％皮质类固醇依赖性（CSD），42.5%对免疫调节剂难治/不耐受。在UC,诱导后缓解和反应分别为32.2%和19.3%，12周时为35.5%和6.5%，52周时为29%和6.5%。在CD中,缓解率为60%,分别为52%和40%。在对INM患者（UC-41，CD-14）的皮质类固醇依赖性和难治性或不耐受中，68.3％的UC在诱导后达到缓解或反应，12周时51.2%,52周时46.3%,和62.3%，CD中的64.3%和42.9%。CD和UC的缓解率分别为66.6%和53.1%。高达74.5%的患者在某个时间点需要皮质类固醇。无皮质类固醇反应/缓解在UC中为17.7％，在CD中为24％。
结论：GMA是UC和CD患者的良好治疗工具。在皮质类固醇依赖性和难治性或不耐受的INM患者中，一年内高达40％的患者避免了生物治疗或手术。
