1. Safety and Efficacy of Granulocyte and Monocyte Adsorption Apheresis in Paediatric Inflammatory Bowel Disease: A Prospective Pilot Study
- Author
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Javier Martín de Carpi, V. Varea, Pere Vilar, C Ribes, Gerardo Prieto, and María Dolores García Novo
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Anti-Inflammatory Agents ,Drug Resistance ,Pilot Projects ,Severity of Illness Index ,Gastroenterology ,Inflammatory bowel disease ,Monocytes ,Crohn Disease ,Internal medicine ,Severity of illness ,Humans ,Medicine ,Leukapheresis ,Prospective Studies ,Colitis ,Child ,Prospective cohort study ,business.industry ,Remission Induction ,medicine.disease ,Ulcerative colitis ,Surgery ,Treatment Outcome ,Apheresis ,Tolerability ,Pediatrics, Perinatology and Child Health ,Colitis, Ulcerative ,Female ,Adsorption ,Safety ,business ,Immunosuppressive Agents ,Granulocytes - Abstract
Objective Selective granulocyte-monocyte adsorption (GMA) apheresis is a safe technique that has shown efficacy in inflammatory bowel disease (IBD), especially in adult steroid-dependent and steroid-refractory ulcerative colitis. GMA apheresis is performed with Adacolumn, a direct blood perfusion system that selectively adsorbs circulating granulocytes and monocytes. Studies on efficacy of GMA apheresis in paediatric IBD are scarce. Our aim was to evaluate efficacy, safety, and tolerability of GMA apheresis in paediatric IBD patients followed for 1 year. Patients and methods Nine patients with a mild to moderate flare-up (6 boys, 3 girls; 5 ulcerative colitis [UC], 4 Crohn disease [CD]) were included. Mean age at inclusion was 13 years and 9 months, and mean disease duration before inclusion was 28 months. All of our patients with UC were steroid-dependent; patients with CD had been unsuccessfully treated with other therapies. GMA apheresis consisted of 5 consecutive weekly sessions lasting 60 minutes each. Results After the 5 sessions, 4 of 5 patients with UC and 1 of 4 patients with CD achieved remission. This remission was maintained in 2 of 4 patients with UC and in the single patients with CD. Patients taking steroids could begin to taper their daily doses after the second apheresis, and 3 of 5 of these patients reached the end of the study steroid-free. GMA apheresis was well tolerated and no severe side effects related to the technique were observed. Conclusions GMA apheresis is a safe, well-tolerated technique in paediatric IBD. As previously reported, we have observed a better efficacy in promoting and maintaining remission, and reducing conventional drugs in patients with UC than in patients with CD.
- Published
- 2008
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