Intermittent Granulocyte and Monocyte Apheresis Versus Mercaptopurine for Maintaining Remission of Ulcerative Colitis: A Pilot Study
Corresponding Author
Atsushi Sakuraba
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Dr Atsushi Sakuraba and Dr Toshifumi Hibi, Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Email: [email protected]; [email protected]Search for more papers by this authorToshiro Sato
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorYuichi Morohoshi
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorKatsuyoshi Matsuoka
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorSusumu Okamoto
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorNagamu Inoue
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorHiromasa Takaishi
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorHaruhiko Ogata
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorYasushi Iwao
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorCorresponding Author
Toshifumi Hibi
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Dr Atsushi Sakuraba and Dr Toshifumi Hibi, Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Email: [email protected]; [email protected]Search for more papers by this authorCorresponding Author
Atsushi Sakuraba
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Dr Atsushi Sakuraba and Dr Toshifumi Hibi, Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Email: [email protected]; [email protected]Search for more papers by this authorToshiro Sato
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorYuichi Morohoshi
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorKatsuyoshi Matsuoka
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorSusumu Okamoto
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorNagamu Inoue
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorHiromasa Takaishi
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorHaruhiko Ogata
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorYasushi Iwao
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Search for more papers by this authorCorresponding Author
Toshifumi Hibi
Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Keio University, Tokyo, Japan
Dr Atsushi Sakuraba and Dr Toshifumi Hibi, Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Email: [email protected]; [email protected]Search for more papers by this authorAbstract
The effect of granulocyte and monocyte adsorption apheresis (GMA) on prevention of relapse of ulcerative colitis (UC) is not clear. This was a pilot open-labeled, prospective, randomized, unblinded study to compare the tolerability and efficacy of intermittent GMA (once every 2 weeks) with mercaptopurine to maintain remission of UC. Twenty-one patients with UC, who had achieved remission by induction therapies were randomly assigned to receive either intermittent GMA (N = 10) or oral mercaptopurine (0.5 mg/kg per day; N = 11). The study period was 24 months. The rate of the patients maintaining remission and the incidences of adverse effects were compared between the two groups. At 24 months, seven of 10 patients (70.0%) on intermittent GMA and seven of 11 patients (63.6%, P = 1.00) on oral mercaptopurine were still in remission. Three patients relapsed in each group. One patient taking mercaptopurine, but none receiving intermittent GMA, dropped out because of adverse effects. Intermittent therapy with GMA was well tolerated and a substantial proportion of patients maintained remission. Intermittent GMA therapy in maintaining remission of UC merits further investigation.
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