Inflammatory bowel disease patients experiencing a loss of response to infliximab regain long-term response after undergoing granulocyte/monocyte apheresis: A case series.
Cytokine
; 103: 25-28, 2018 03.
Article
en En
| MEDLINE
| ID: mdl-29291447
ABSTRACT
Up to 50% of patients with ulcerative colitis (UC) or Crohn's disease (CD) experience a loss of response (LOR) to infliximab after an initial response to the drug. Granulocyte/monocyte apheresis (GMA) with the Adacolumn depletes the activated myeloid leukocytes that are known to exacerbate and perpetuate inflammatory bowel diseases, but GMA has hitherto not been applied to patients with LOR to infliximab. We report three cases (2 UC and 1CD) with LOR to maintenance infliximab therapy that received one GMA session/week for 3 consecutive weeks or more. The disease severity was assessed from the CD activity index or partial Mayo score, and the trough infliximab (TI) level was measured. Upon GMA therapy, all three patients achieved remission for up to 15â¯months with maintenance infliximab alone. The average plasma TI increased from 0.91⯵g/mL to 1.46⯵g/mL, with concomitant decreases of C-reactive protein (from 2.33â¯mg/dL to 0.78â¯mg/dL), interleukin-6 (from 8.4â¯pg/mL to 3.4â¯pg/mL), and interleukin-17A (from 0.21â¯pg/mL to 0.03â¯pg/mL). To our best knowledge, this is the first report of adding a non-drug GMA to restore the efficacy of infliximab. The outcomes, albeit in three cases, are relevant in therapeutic settings and should inspire further studies in a larger number of patients.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Colitis Ulcerosa
/
Leucaféresis
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Infliximab
Tipo de estudio:
Observational_studies
Límite:
Adult
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Cytokine
Asunto de la revista:
ALERGIA E IMUNOLOGIA
Año:
2018
Tipo del documento:
Article