Concomitant pharmacologic medications influence the clinical outcomes of granulocyte and monocyte adsorptive apheresis in patients with ulcerative colitis: A multicenter retrospective cohort study
Concomitant pharmacologic medications influence the clinical outcomes of granulocyte and monocyte adsorptive apheresis in patients with ulcerative colitis: A multicenter retrospective cohort study
复制标题
DOI：
10.1002/jca.22040
复制
发表时间：
2023-01-13
影响因子：
1.5
通讯作者：
Fujiya，Mikihiro
中科院分区：
文献类型：
--
作者：
Ueno，Nobuhiro;Sugiyama，Yuya;Fujiya，Mikihiro
研究背景Adacolumn吸附粒细胞和单核细胞单采术（GMA）已被用作活动期溃疡性结肠炎（UC）患者的缓解诱导治疗。在此，我们调查了合并用药的影响，在缓解诱导GMA在活动性UC.MethodsThis多中心回顾性队列研究包括UC患者在日本的5个独立机构从2011年1月至2021年7月接受GMA。结果共纳入133例患者，其中133例患者的临床缓解率（CR）与合并用药有关。74例患者在GMA后达到CR。多变量分析显示，5-氨基水杨酸合并用药、马约内镜分项评分（MES）和免疫抑制剂（IM）合并用药仍然是GMA后CR的预测因素。在MES为2的患者中进行的亚组分析中，与IM合并用药被证明是GMA后CR的显著负性因素（P= 0.042，OR 0.354）。74例在GMA后达到CR的患者随访52周。在多变量分析中，IM维持治疗被证明是持续CR长达52周的显著积极因素（P= 0.038，OR 2.214）。此外，与生物制剂和IMs的患者持续CR率显着高于生物制剂的患者只有（P= .002）。结论GMA是更有效的治疗下复发的活动性UC患者没有IMs。此外，在GMA后接受生物制剂维持治疗的患者中应考虑添加IM。
BackgroundGranulocyte and monocyte adsorptive apheresis (GMA) with Adacolumn has been used as a remission induction therapy for patients with active ulcerative colitis (UC). Herein, we investigated the influence of concomitant medications in the remission induction of GMA in patients with active UC.MethodsThis multicenter retrospective cohort study included patients with UC underwent GMA in five independent institutions in Japan from January 2011 to July 2021. Factors including concomitant medications associated with clinical remission (CR) were analyzed statistically.ResultA total of 133 patients were included. Seventy‐four patients achieved a CR after GMA. The multivariable analysis revealed that concomitant medication with 5‐aminosalicylic acid, Mayo endoscopic subscore (MES), and concomitant medication with immunosuppressors (IMs) remained as predictors of CR after GMA. In the subgroup analysis in patients with MES of 2, concomitant medication with IMs was demonstrated as a significant negative factor of CR after GMA (P= .042, OR 0.354). Seventy‐four patients who achieved CR after GMA were followed up for 52 weeks. In the multivariable analysis, the maintenance therapy with IMs was demonstrated as a significant positive factor of sustained CR up to 52 weeks (P= .038, OR 2.214). Furthermore, the rate of sustained CR in patients with biologics and IMs was significantly higher than that in patients with biologics only (P= .002).ConclusionGMA was more effective for patients with active UC that relapsed under treatment without IMs. Furthermore, the addition of IMs should be considered in patients on maintenance therapy with biologics after GMA.