Efficacy of cytapheresis in patients with ulcerative colitis showing insufficient or lost response to biologic therapy

作     者：Masahiro Iizuka Takeshi Etou Shiho Sagara 

作者机构：Akita Health Care CenterAkita Red Cross HospitalAkita 010-0001Japan Department of GastroenterologyAkita Red Cross HospitalAkita 010-1495Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2022年第28卷第34期

页      面：4959-4972页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Ulcerative colitis Inflammatory bowel disease Cytapheresis Granulocyte and monocyte adsorptive apheresis Anti-tumor necrosis factor-αantibody Combination therapy 

摘      要：For the optimal management of refractory ulcerative colitis(UC),secondary loss of response(LOR)and primary non-response to biologics is a critical *** article aimed to summarize the current literature on the use of cytapheresis(CAP)in patients with UC showing a poor response or LOR to biologics and discuss its advantages and ***,we summarized the efficacy of CAP in patients with UC showing insufficient response to thiopurines or immunomodulators(IM).Eight studies evaluated the efficacy of CAP in patients with UC with inadequate responses to thiopurines or *** were no significant differences in the rate of remission and steroid-free remission between patients exposed or not exposed to thiopurines or *** studies evaluated the efficacy of CAP in patients with UC showing an insufficient response to biologic *** remission rates of biologics exposed or unexposed patients were 29.4%and 44.2%,*** studies evaluated the efficacy of CAP in combination with biologics in patients with inflammatory bowel disease showing a poor response or LOR to *** rates of remission/response and steroid-free remission in patients with UC ranged 32%-69%(mean:48.0%,median:42.9%)and 9%-75%(mean:40.7%,median:38%),*** had the same effectiveness for remission induction with or without prior failure on thiopurines or IM but showed little benefit in patients with UC refractory to *** heterogeneity existed in the efficacy of the combination therapy with CAP and biologics,these combination therapies induced clinical remission/response and steroid-free remission in more than 40%of patients with UC refractory to biologics on *** the excellent safety profile of CAP,this combination therapy can be an alternative therapeutic strategy for UC refractory to *** prospective studies are needed to understand the efficacy of combination therapy with CAP and biologics.