| Theme |
How Do You Choose Treatment Strategies for IBD Patients with a Critical Situation? |
| Title |
Reasons for Performing Granulocytes and Monocytes Adsorptive Apheresis Prior to Corticosteroids Administration for Active Ulcerative Colitis |
| Author |
Takumi Fukuchi |
Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital |
| Author |
Keiji Shimazu |
Department of Nephrology, Tohoku University Graduate School of Medicine |
| [ Summary ] |
Granulocyte and monocyte adsorptive apheresis (GMA) using Adacolumns is a natural biologic therapy for selectively removing granulocytes/macrophages from peripheral blood to reduce the production of inflammatory cytokines. We reported that a twice‒weekly regimen (intensive) of GMA was effective and had no severe adverse effect in steroid‒naive patients or those with free ulcerative colitis (UC) even when steroid naivete/free active UC had a cytomegalovirus reactivation in the intestinal tract mucosa without administration of antiviral agents. However, conventional GMA may often be avoided in the treatment of active UC because of the need to maintain two blood access routes through the antecubital veins, which is required for the GMA system. Recently, we introduced a single‒needle technique for GMA and demonstrated no striking differences in the clinical responses and adverse effects between single‒ and double‒needle intensive GMA in steroid-naive patients or those with free active UC. Thus, the reasons for performing GMA prior to corticosteroid administration in patients with active UC are adequate efficacy as an alternative to corticosteroids, fewer severe adverse effects than corticosteroids, and to avoid the need to maintain two blood access routes for induction of the single‒needle technique. |