Exploratory Study of the Effectiveness of Granulocyte and Monocyte Adsorptive Apheresis Before Initiation of Steroids in Patients With Active Ulcerative Colitis (EXPECT Study): A Multicenter Prospective Clinical Trial

Kazuki Kakimoto; Minoru Matsuura; Takumi Fukuchi; Hitoshi Hongo; Tsuguhiro Kimura; Nobuo Aoyama; Yorihide Okuda; Kazuki Aomatsu; Noriko Kamata; Yoko Yokoyama; Chiemi Mizuno; Takuya Inoue; Takako Miyazaki; Shiro Nakamura; Kazuhide Higuchi; Hiroshi Nakase

doi:10.1093/crocol/otaa073

Exploratory Study of the Effectiveness of Granulocyte and Monocyte Adsorptive Apheresis Before Initiation of Steroids in Patients With Active Ulcerative Colitis (EXPECT Study): A Multicenter Prospective Clinical Trial

Crohns Colitis 360. 2020 Sep 23;2(4):otaa073. doi: 10.1093/crocol/otaa073. eCollection 2020 Oct.

Authors

Affiliations

¹ 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki, Osaka, Japan.
² Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan.
³ Department of Gastroenterology and Hepatology, Iseikai Hospital, Osaka, Osaka, Japan.
⁴ Department of Gastroenterology, Fujita Gastroenterological Hospital, Takatsuki, Osaka, Japan.
⁵ Department of Gastroenterology, Gastrointestinal Endoscopy and IBD Center, Aoyama Medical Clinic, Kobe, Hyogo, Japan.
⁶ Department of Gastroenterology, Otemae Hospital, Osaka, Osaka, Japan.
⁷ Department of Gastroenterology, Izumiotsu Municipal Hospital, Izumiotsu, Osaka, Japan.
⁸ Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan.
⁹ Department of Intestinal Inflammation Research, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
¹⁰ Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Osaka, Japan.
¹¹ Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.

Abstract

Background: Granulocyte and monocyte adsorptive apheresis (GMA) has been used for therapy of steroid-dependent/refractory ulcerative colitis (UC). The aim of this study was to investigate the effectiveness of GMA in UC patients not receiving steroids.

Methods: We conducted a single-arm, open-label, and multicenter prospective clinical trial. UC patients who had insufficient responses to 5-aminosalicylic acid received GMA twice a week for 5 weeks.

Results: The response rate of all patients was 58.2% (39/67). Of the 39 patients who achieved a response, 74.4% achieved endoscopically confirmed mucosal healing.

Conclusions: GMA shows effectiveness in inducing remission in UC patients not receiving steroid.

Keywords: COVID-19; granulocyte and monocyte adsorptive apheresis; inflammatory bowel disease; steroid naive.