Real world experience with granulocyte and monocyte adsorptive apheresis (ADACOLUMN®) in patients with refractory inflammatory bowel disease: a retrospective observational multicenter cohort study.

内容摘要

The exact positioning of granulocyte and monocyte adsorptive apheresis (GMA) using the ADACOLUMN® system (JIMRO, Takasaki, Japan) remains unclear in the era of advanced therapy. We conducted a retrospective multi-centre cohort study which included all patients with active Crohn's disease (CD) or ulcerative colitis (UC) who were treated with GMA alone or in combination with advanced therapy at 15 French tertiary care centres between 2007 and 2024. A total of 129 patients with IBD (median age: 40.9 years; IQR: 29.3-58.1; 79% with UC; IBD duration: 7.0 [2.9-13.1] years; 97 (75%) had been previously exposed to advanced therapies) were included. In patients with UC, the rates of clinical remission, steroid-free clinical remission, and response at week 14 were 33.3%, 27.5%, and 52.0%, respectively. In patients with CD, the corresponding rates were 33.3%, 29.6% and 66.7%, respectively. At week 54, 33 patients (26%) were still receiving maintenance GMA therapy, including 12 with CD and 21 with UC. Among these patients, the rates of steroid-free clinical remission were 71.4% for those with UC and 41.7% for those with CD. A total of 26 adverse events were reported, 16 of which were an exacerbation of IBD activity. In this real-world cohort of patients with refractory IBD, GMA induced steroid-free clinical remission in one-third of patients with CD and UC by week 14. A significant proportion of patients who continued GMA therapy beyond week 14 experienced ongoing clinical benefits.