Maintenance apheresis safe for ulcerative colitis patients

Use of apheresis as maintenance therapy for ulcerative colitis (UC) is well tolerated, although it does not lead to a significantly higher endoscopic remission rate at month 12 compared with no treatment, a study has shown.

A total of 164 patients with remitting UC induced by granulocyte and monocyte adsorption apheresis or leukocytapheresis were randomly assigned to the apheresis group (twice per month for 12 months) or the control group (no apheresis treatment). There was no significant between-group difference in the distribution of clinical characteristics (sex, age, extent of disease, duration of disease, and clinical and endoscopic severity) at baseline.

The primary endpoint of cumulative clinical remission rate (Mayo score ≤2) at month 12 was similar in the apheresis and control groups (46.6 percent vs 36.4 percent; p=0.1621).

Meanwhile, treatment with apheresis led to a significantly higher rate of endoscopic remission at 12 months compared with controls (42.5 percent vs 25.9 percent; p=0.0480). Active treatment was likewise associated with higher rates of clinical remission (47.5 percent vs 32.1 percent; p=0.0540) and complete endoscopic remission (33.8 percent vs 19.8 percent; p=0.0513), but the difference was not meaningful.

There were no severe adverse events documented in either group.

The present data suggest that maintenance therapy with apheresis may be appropriate in patients at high risk of adverse effects or those who refuse immunosuppressant treatment, the researchers said.