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Granulocyte‐Monocyte Apheresis as an Adjuvant Therapy to Anti‐Tumor Necrosis Factor Drugs for Ulcerative Colitis
Authors:Iago Rodríguez‐Lago  Laura Gómez‐Irwin  Encarnación Fernández  Rebeca Higuera  José Luis Cabriada
Institution:1. Gastroenterology Department, Hospital de Galdakao, Galdakao, Vizcaya, Spain;2. Gastroenterology Department, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain;3. Dialysis Unit, Nephrology Department, Hospital de Galdakao, Galdakao, Vizcaya, Spain;4. Gastroenterology Department, Hospital de San Eloy, Baracaldo, Vizcaya, Spain
Abstract:Biologic anti‐tumor necrosis factor (TNF) drugs have demonstrated their efficacy for the treatment of ulcerative colitis. Nevertheless, some patients will not respond to this therapy or will develop loss of response. Leukapheresis is the main non‐pharmacological therapy for some immune‐mediated diseases. The aim of our study was to describe our experience with this therapy in ulcerative colitis patients after loss of response to anti‐TNF treatment. Leukapheresis was indicated in four patients with left‐sided or extensive colitis because of partial response to biological therapy or secondary loss of response to it. All patients received 8 to 10 sessions in an intensive regimen. Globally, a decrease in the Mayo score was observed. The overall response rate was 50% with one patient who displayed sustained response. No patients have required colectomy during follow‐up. Adjuvant treatment with leukapheresis in patients with inadequate response to anti‐TNF treatment showed some beneficial effect, although of limited duration, in patients with ulcerative colitis.
Keywords:Anti‐tumor necrosis factor  Biologic drug  Inflammatory bowel disease  Leukocytapheresis  Ulcerative colitis
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