Single-Needle Intensive Granulocyte and Monocyte Adsorptive Apheresis Is Suitable for Elderly Patients With Active Ulcerative Colitis Taking no Corticosteroids or Biologics

Ther Apher Dial. 2019 Jun;23(3):224-232. doi: 10.1111/1744-9987.12819. Epub 2019 Jun 6.

Abstract

Twice-weekly intensive granulocyte/monocyte adsorptive apheresis is effective and safe for ulcerative colitis, but maintaining two blood access routes is problematic. We previously reported that intensive granulocyte/monocyte adsorptive apheresis using a single needle in ulcerative colitis is effective and safe. We hypothesized that the efficacy and safety of single-needle intensive granulocyte/monocyte adsorptive apheresis for ulcerative colitis would especially benefit the elderly. We enrolled 17 elderly ulcerative colitis patients to receive single-needle intensive granulocyte/monocyte adsorptive apheresis, 27 elderly ulcerative colitis patients to receive double-needle intensive granulocyte/monocyte adsorptive apheresis, and 52 nonelderly ulcerative colitis patients to receive single-needle intensive granulocyte/monocyte adsorptive apheresis. Remission and mucosal healing rates after treatment did not differ significantly between elderly ulcerative colitis patients receiving single-needle apheresis and the other two groups. In addition, no serious adverse effects, including blood clots, were observed in single-needle intensive granulocyte/monocyte adsorptive apheresis patients. Single-needle intensive granulocyte/monocyte adsorptive apheresis might be a novel alternative therapeutic option for elderly ulcerative colitis patients before considering corticosteroids.

Keywords: Corticosteroid naïve; Elderly; Intensive granulocyte and monocyte adsorptive apheresis; Single-needle induction; Ulcerative colitis.

Publication types

  • Comparative Study

MeSH terms

  • Adrenal Cortex Hormones
  • Adsorption
  • Aged
  • Aged, 80 and over
  • Biological Products
  • Cohort Studies
  • Colitis, Ulcerative / diagnosis*
  • Colitis, Ulcerative / therapy*
  • Female
  • Geriatric Assessment
  • Granulocytes / cytology
  • Humans
  • Japan
  • Leukapheresis / methods*
  • Male
  • Middle Aged
  • Monocytes / cytology
  • Needles
  • Patient Safety*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Biological Products