Granulocyte/monocyte adsorptive apheresis for the treatment of therapy-refractory chronic active ulcerative colitis

Scand J Gastroenterol. 2018 Apr;53(4):442-448. doi: 10.1080/00365521.2018.1447598. Epub 2018 Mar 7.


Objectives: Current options for patients with steroid-dependent, chronic-active ulcerative colitis (UC) with insufficient response/intolerance to immunosuppressants (ISs) and/or biologics are limited. The aim of this study was to assess the long-term outcome of granulocyte/monocyte adsorptive (GMA) apheresis (Adacolumn®) in this population.

Materials and methods: Ninety five adults with steroid-dependent active UC and insufficient response/intolerance to IS and/or TNF inhibitors received 5-8 aphereses in a single induction series of ≤10 weeks. Endpoints included rates of remission (clinical activity index [CAI] ≤ 4) at weeks 24 and 48.

Results: Of 94 patients (ITT population), remission and response rates were 34.0% and 44.7% at week 24, and 33.0% and 39.4% at week 48. Among 30 patients with prior failure of IS and biologics, 33.3% and 20.0% were in remission at weeks 24 and 48. At both weeks, 19.2% of patients achieved steroid-free remission. Sustained remission or response occurred in 27.7% of patients at 48 weeks. The cumulative colectomy rate at week 96 was 23.4%. Safety was consistent with previous findings.

Conclusions: This study confirms findings of the 12-week interim analysis and demonstrates that GMA apheresis provides a safe and beneficial long-term outcome for patients with chronic active UC resistant/intolerant to IS and/or TNF inhibitors.

Keywords: Ulcerative colitis; devices; granulocyte/monocyte adsorptive apheresis; inflammatory bowel disease; large intestine.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adsorption
  • Adult
  • Chronic Disease
  • Colectomy / statistics & numerical data
  • Colitis, Ulcerative / blood
  • Colitis, Ulcerative / therapy*
  • Female
  • France
  • Granulocytes*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Leukapheresis / methods*
  • Male
  • Middle Aged
  • Monocytes*
  • Patient Safety
  • Remission Induction
  • Steroids / therapeutic use


  • Immunosuppressive Agents
  • Steroids