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

• Published in: Crohn's & colitis 360 2020-10, Vol.2 (4), p.otaa073-otaa073
• Main Authors: Kakimoto, Kazuki, Matsuura, Minoru, Fukuchi, Takumi, Hongo, Hitoshi, Kimura, Tsuguhiro, Aoyama, Nobuo, Okuda, Yorihide, Aomatsu, Kazuki, Kamata, Noriko, Yokoyama, Yoko, Mizuno, Chiemi, Inoue, Takuya, Miyazaki, Takako, Nakamura, Shiro, Higuchi, Kazuhide, Nakase, Hiroshi
• Format: Article
• Language: English
• Subjects: Observations and Research
• ISSN: 2631-827X; 2631-827X
• DOI: 10.1093/crocol/otaa073

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. Lay Summary EXPECT study demonstrates that granulocyte and monocyte adsorptive apheresis has promising effectiveness with regard to inducing remission in patients with active ulcerative colitis (UC) who are not receiving steroid treatment. The first episode of UC was an independent predictor of a response in multiple logistic regression.