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P560 Concomitant granulocyte and monocyte adsorption apheresis accelerates clinical efficacy and mucosal healing of colonic lesions in patients with active Crohn’s disease

S. Yasukawa*, F. Hirai, Y. Takada, Y. Yano

Fukuoka University Chikushi Hospital, Department of Gastroenterology, Chikushino, Japan

Background

The efficacy of concomitant apheresis therapy for Crohn’s disease (CD) is not clear. The aim of this study was to clarify the clinical utility of concomitant granulocyte and monocyte adsorption apheresis (GMA) in patients with active CD.

Methods

Patients who showed the resistance to other treatments, such as steroid and TNF-alfa inhibitor, and underwent GMA therapy at our department were included. The clinical features, short-term outcomes, and safety of GMA were retrospectively evaluated. Endoscopic disease severity was assessed before and after GMA. Clinical remission was defined as a Crohn’s Disease Activity Index (CDAI) score of < 150 and clinical response was defined as a decrease in CDAI of 25% or more from baseline. Severity of disease in the large intestine, and was endoscopically evaluated using a 5-point grading score. Mucosal healing was defined as a score of 2 or less after treatment.

Results

Twenty-four patients were included in this study. The rates of clinical remission and clinical response with concomitant GMA were 46% (11/24) and 71% (17/24), respectively. Endoscopic severity was evaluated in 18 patients. Mucosal healing was achieved in 8 (44%) patients. There were no severe adverse effects to GMA that required discontinuation of therapy.

Conclusion

Concomitant GMA not only improved clinical outcome but also benefited treatment of colonic mucosal lesions in patients with CD who showed resistance to other treatments.