# Comparison of early versus late addition of granulocyte and monocyte adsorption for incomplete remission induction in ulcerative colitis

## TL;DR

This study compares the effectiveness of adding granulocyte and monocyte adsorption therapy early versus late in treating ulcerative colitis, finding that early addition may lead to faster remission.

## Contribution

The novel contribution is evaluating the timing of granulocyte and monocyte adsorption addition in ulcerative colitis treatment.

## Key findings

- Early addition of GMA did not significantly improve remission rates but led to shorter time to remission.
- 24 out of 32 early GMA patients achieved remission compared to 18 out of 27 in the late group.
- The early GMA group had a significantly shorter mean time to remission induction (P < 0.001).

## Abstract

Ulcerative colitis (UC) is characterized by repeated relapse and remission. Because no fundamental therapeutic strategy has been established, the treatment goal is generally to maintain the remission phase for a long period after rapid remission induction. Granulocyte and monocyte adsorption (GMA) for UC is reportedly quite safe because it does not affect immunosuppression. Moreover, it is useful in combination with other remission induction therapy. The aim of this study was to evaluate the difference in efficacy by the timing of the addition of GMA with corticosteroids, calcineurin inhibitors, and anti‐cytokine therapy for active UC.

The study included 59 patients. Patients who started GMA of 5–11 days were in the early GMA combination group. Patients who started GMA 12 days or more were in the late GMA combination group. The primary endpoint was difference in the effect of additional GMA according to the timing of the intervention. The secondary endpoint was difference in the time to remission induction between the two groups.

Of the 32 early GMA group patients, 24 achieved remission induction. Of the 27 late group patients, 18 achieved remission induction. No significant difference in induction rates was found (P = 0.481). The early group had shorter mean time to remission induction (P < 0.001).

In conclusion, results suggest that early addition of GMA might lead to earlier remission in patients who have had an inadequate response to remission induction therapy with corticosteroids, calcineurin inhibitors, and anti‐cytokine therapy.

Early addition of granulocyte and monocyte adsorption might lead to earlier remission in patients who have had an inadequate response to remission induction therapy with corticosteroids, calcineurin inhibitors, and anti‐cytokine therapy.