Cytapheresis.

In the inflammatory bowel disease (IBD) therapeutic settings, leukocytapheresis (LCAP), and Adsorptive Granulocyte/Monocyte Apheresis (GMA) are currently the two major cytapheresis (CAP) strategies approved and are applied to treat patients with IBD, which has become refractory to conventional pharmacological intervention. Further, based on our recently concluded prospective multi-centre studies, we can now report on the therapeutic efficacy, safety and demographic factors, which identify ulcerative colitis (UC) patients as responders, or otherwise as non-responders to CAP. Further, in Crohn's disease (CD) patients, hitherto studies have not identified CAP-responder features. Regarding the maintenance of remission after GMA-induced remission, shorter duration and corticosteroid responder background were significant factors for maintenance of remission, while corticosteroid dependent UC was associating with early relapse. Considering LCAP, intensive therapy was more effective in UC patients with high baseline clinical activity score and a higher biomarker than weekly LCAP. Additionally, we have started assessing the efficacy of CAP in patients with IBD refractory to anti- tumour necrosis factor (TNF)-a biologics, and hope our work may lead to better management of drug refractory IBD. In conclusion, demographic features, which identify a patient as a potential responder to CAP or any given therapeutic intervention should guide to stop futile use of medical resources and shorten morbidity time for non- responder patients who may opt for an alternative therapy.