In a new study entitled “Combination Therapy With Adalimumab Plus Intensive Granulocyte and Monocyte Adsorptive Apheresis in Patients With Refractory Ulcerative Colitis,” a team of researchers investigated if a combined therapy of adalimumab with granulocyte and monocyte adsorptive apheresis offers benefits when administered to patients with refractory ulcerative colitis who failed to respond to conventional therapies (corticosteroids, azathioprine, and/or aminosalicylic acid). The study was published in the Journal of Clinical Medicine Research.
Patients with moderate to severe ulcerative colitis, a form of inflammatory bowel disease (IBD) that causes inflammation and ulcers in the colon, who failed to achieve clinical remission or respond to conventional therapy, were reported to experience successful results from adalimumab, ADA (a tumor necrosis factor, TNF, inhibiting drug that binds to TNF and prevents TNF-induced inflammation). However, the percentage of patients responding to ADA monotherapy was only 16.5% after 8 weeks of therapy.
In this new study, a team of researchers investigated the efficacy of a different therapy called granulocyte and monocyte adsorptive apheresis (GMA) when added to ADA. GMA uses a device that allows the remotion of activated granulocytes and monocytes — cells known to promote IBD — from a patient’s blood. The blood, free of these particular cells, is then returned to the patient.
The team performed a retrospective analysis of a 10-week therapy combining ADA plus intensive GMA (two sessions per week) in refractory ulcerative colitis patients (refractory describes a disease or condition which does not respond to attempted forms of treatment). The researchers also assessed the clinical outcomes of patients after 52 weeks treatment under ADA monotherapy. In total, the team analyzed the results of 10 patients with moderate and severe ulcerative colitis recruited in the Nagoya City University Hospital in Japan.
Out of nine patients who were treated with the combined therapy – ADA with GMA – 55.6% exhibited cumulative clinical remission after 10 weeks of treatment; in 33.3% of the patients, the remission was achieved in 52 weeks when maintained under an additional monotherapy of ADA. The percentage of patients with mucosal healing at 10 weeks was 66.7%.
The research team highlights that although additional studies with a larger number of patients are required to validate the results, their findings support the combination of ADA therapy with intensive GMA as an efficient treatment option for inducing clinical remission in refractory ulcerative colitis patients.
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