Refractory Ulcerative Colitis Improved by Scheduled Combination Therapy of Vedolizumab and Granulocyte and Monocyte Adsorptive Apheresis

Intern Med. 2020 Dec 1;59(23):3009-3014. doi: 10.2169/internalmedicine.5302-20. Epub 2020 Jul 28.

Abstract

Granulocyte and monocyte adsorptive apheresis (GMA) is occasionally introduced as an alternative combination therapy after loss of response to biologics in ulcerative colitis (UC) patients. However, there have been no reports of the concomitant use of vedolizumab (VDZ) and GMA for the initial induction of UC. A 20-year-old man with refractory UC was admitted for recrudescence. VDZ monotherapy had previously been introduced but was ineffective. Therefore, he received scheduled combination of VDZ and GMA and achieved clinical remission. The combination of two different approaches to inhibit the migration of leukocytes into the inflamed tissue led to satisfactory clinical outcomes.

Keywords: apheresis; clinical remission; ulcerative colitis; vedolizumab.

Publication types

  • Case Reports

MeSH terms

  • Adsorption / drug effects*
  • Adult
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Blood Component Removal / methods*
  • Colitis, Ulcerative / drug therapy*
  • Combined Modality Therapy / methods*
  • Granulocytes / drug effects*
  • Humans
  • Male
  • Monocytes / drug effects*
  • Secondary Prevention / methods
  • Treatment Outcome
  • Young Adult

Substances

  • Antibodies, Monoclonal, Humanized