%0 Journal Article
%T Combination of granulocyte-monocyte apheresis and ustekinumab: Multicentre and retrospective study.
%A Rodríguez-Lago I
%A Herrera-deGuise C
%A Boscá-Watts M
%A Rodríguez C
%A Leo-Carnerero E
%A Íñiguez MC
%A Cañete F
%A Chacón S
%A Cuarán C
%A Elorza A
%A Guerra-Del-Río E
%A Iglesias E
%A Sánchez D
%A Barreiro-de Acosta M
%A Ginard D
%A Cabriada JL
%J Gastroenterol Hepatol
%V 0
%N 0
%D 2024 May 6
%M 38710466
%F 5.867
%R 10.1016/j.gastrohep.2024.502195
%X <B>OBJECTIVE: </B>Granulocyte-monocyte apheresis (GMA) has shown to be safe and effective in ulcerative colitis (UC), also in combination with biologics, mainly with anti-TNF. The aim of this study was to evaluate the efficacy and safety of combining GMA after primary non-response (PNR) or loss of response (LOR) to ustekinumab (UST) in patients with UC.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>GMA can recapture the response to UST in selected cases of UC after PNR or LOR to this drug.