IBD Center, Sapporo Kosei General Hospital, Kita-3, Higashi-8, Chuo-ku, Sapporo, Hokkaido, 060-0033, Japan.
Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8431, Tokyo, Japan.
BMC Gastroenterol. 2019 Nov 21;19(1):196. doi: 10.1186/s12876-019-1110-1.
The available information on granulocyte and monocyte adsorptive apheresis (GMA) in patients with inflammatory bowel disease (IBD) under special situations remains unclear. We conducted a retrospective, multicentre cohort study to evaluate the safety and effectiveness of GMA in patients with IBD under special situations.
This study included patients with ulcerative colitis (UC) or Crohn's disease who had at least one special situation feature and who had received GMA between November 2013 and March 2017. The incidence of adverse events (AEs) was compared in relation to the special situation, and patient background factors related to an AE were identified. For patients with UC, clinical remission was defined as a partial Mayo score of ≤2.
A total of 437 patients were included in this study. The incidence of AEs among the elderly patients (11.2%) was similar in all patients (11.4%), whereas the incidences of AEs in patients on multiple immunosuppressant medications (15.2%), patients with anaemia (18.1%) and paediatric/adolescent patients (18.9%) were higher than that in all patients (11.4%). In multivariate analysis, anaemia and concomitant immunosuppressant medications were independently associated with the incidence of AEs. Clinical remission was achieved in 46.4% of the patients with UC.
The incidence of AEs in the elderly patients was not higher than that in all patients, whereas the incidence of AE was higher in patients with anaemia and those on multiple immunosuppressant medications than that in all patients. GMA is a safe treatment option in elderly patients with IBD.
在特殊情况下，关于粒细胞和单核细胞吸附性血浆分离术（GMA）在炎症性肠病（IBD）患者中的应用的信息仍然有限。我们进行了一项回顾性、多中心队列研究，以评估 GMA 在特殊情况下 IBD 患者中的安全性和有效性。
本研究纳入了至少存在一种特殊情况特征且在 2013 年 11 月至 2017 年 3 月期间接受 GMA 治疗的溃疡性结肠炎（UC）或克罗恩病患者。比较了与特殊情况相关的不良事件（AE）发生率，并确定了与 AE 相关的患者背景因素。对于 UC 患者，临床缓解定义为部分 Mayo 评分≤2。
本研究共纳入 437 例患者。老年患者（11.2%）的 AE 发生率与所有患者（11.4%）相似，而接受多种免疫抑制剂治疗的患者（15.2%）、贫血患者（18.1%）和儿科/青少年患者（18.9%）的 AE 发生率高于所有患者（11.4%）。多变量分析显示，贫血和同时使用免疫抑制剂与 AE 发生率相关。UC 患者中有 46.4%达到临床缓解。
老年患者的 AE 发生率并不高于所有患者，而贫血和接受多种免疫抑制剂治疗的患者的 AE 发生率高于所有患者。GMA 是老年 IBD 患者的一种安全治疗选择。
