Journal Article

Safety and effectiveness of granulocyte and monocyte adsorptive apheresis in patients with inflammatory bowel disease in special situations: a multicentre cohort study

Shibuya, Tomoyoshi, Aoyama, Nobuo, Yamamoto, Takayuki, Osada, Taro, Kokuma, Seiichiro, Saito, Daisuke, Hosoi, Eiji, Motoya, Satoshi, Tanida, Satoshi, Kobayashi, Toshihisa, Ito, Hiroaki, Tanaka, Hiroki, Hongo, Hitoshi, Nojima, Masanori, Mizuno, Chiemi

2019

Overview

Background The available information on granulocyte and monocyte adsorptive apheresis (GMA) in patients with inflammatory bowel disease (IBD) under special situations remains unclear. We conducted a retrospective, multicentre cohort study to evaluate the safety and effectiveness of GMA in patients with IBD under special situations. Methods This study included patients with ulcerative colitis (UC) or Crohn’s disease who had at least one special situation feature and who had received GMA between November 2013 and March 2017. The incidence of adverse events (AEs) was compared in relation to the special situation, and patient background factors related to an AE were identified. For patients with UC, clinical remission was defined as a partial Mayo score of ≤2. Results A total of 437 patients were included in this study. The incidence of AEs among the elderly patients (11.2%) was similar in all patients (11.4%), whereas the incidences of AEs in patients on multiple immunosuppressant medications (15.2%), patients with anaemia (18.1%) and paediatric/adolescent patients (18.9%) were higher than that in all patients (11.4%). In multivariate analysis, anaemia and concomitant immunosuppressant medications were independently associated with the incidence of AEs. Clinical remission was achieved in 46.4% of the patients with UC. Conclusions The incidence of AEs in the elderly patients was not higher than that in all patients, whereas the incidence of AE was higher in patients with anaemia and those on multiple immunosuppressant medications than that in all patients. GMA is a safe treatment option in elderly patients with IBD.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adalimumab / Adrenal Cortex Hormones - therapeutic use / Age Factors / Anemia / Anemia - complications / Apheresis / Blood / Blood Component Removal - adverse effects / Blood Component Removal - methods / Care and treatment / Certolizumab pegol / Cohort analysis / Colitis / Colitis, Ulcerative - drug therapy / Colitis, Ulcerative - therapy / Comparative analysis / Crohn Disease - drug therapy / Crohn Disease - therapy / Crohn's disease / Drug dosages / Drugs / Elderly / Elderly patient / Elderly patients / Gastroenterology / Gastrointestinal diseases / Geriatrics / GMA / Granulocyte and monocyte adsorptive apheresis / Granulocytes / Hepatology / Humans / Immunosuppressive agents / Immunosuppressive Agents - therapeutic use / Inflammatory bowel disease / Inflammatory bowel diseases / Internal Medicine / Intestinal disorders / Intestine / Laboratories / Leukocytes (granulocytic) / Marketing / Medical research / Medicine / Medicine & Public Health / Molecular weight / Monocytes / Multivariate analysis / Patients / Psoriasis / Remission / Remission Induction / Research Article / Retrospective Studies / Risk Factors / Safety and security measures / Skin cancer / Surveillance / Treatment Outcome / Tumor necrosis factor-TNF / Ulcerative colitis