| Theme |
Tips and up-to-date of the medical therapy for ulcerative colitis |
| Title |
New evidence on cytapheresis (CAP) for ulcerative colitis |
| Author |
Takumi Fukuchi |
Departments of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital |
| Author |
Keiko Shimoyama |
Departments of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital |
| Author |
Satoshi Ubukata |
Department of Gastroenterology and Hepatology, Kobe Hokuto Hospital |
| Author |
Shintaro Koyama |
Department of Gastroenterology and Hepatology, Kobe Hokuto Hospital |
| Author |
Megumi Iwata |
Department of Nephrology, Osaka Saiseikai Nakatsu Hospital |
| Author |
Keiji Shimazu |
Department of Nephrology, Osaka Saiseikai Nakatsu Hospital |
| [ Summary ] |
A number of studies showed higher clinical remission rates with granulocytes/macrophages adsorptive apheresis (GMA) in active UC patients without corticosteroid use than in steroid-dependent/refractory UC patients. In addition, most studies reported that GMA as a natural biologic therapy for selectively removing granulocytes/macrophages from peripheral blood did not lead to opportunistic infections or adverse effects. However, many allergic side effects were reported when active UC patients were administered GMA with nafamostat mesilate. Since the change of the anti-coagulation drug from nafamostat mesilate to heparin sodium, we reported adequate efficacy and few side effects from intensive GMA in active UC patients without corticosteroids. Of note, no active UC patient exhibited increased hematochezia in response to intensive GMA under heparin sodium. GMA can be initiated prior to corticosteroids with the use of heparin sodium as an anti-coagulation drug. Thus, GMA using heparin sodium could be an effective and safe therapeutic option in active UC without corticosteroids, even when active UC outpatients receive GMA in no-admission bed clinics. |