Granulocyte and monocyte adsorptive apheresis induced remission in a CD patient

[Mark in Seattle]

I've been reading a little bit about granulocyte and monocyte adsorptive apheresis, which as I understand, is a form of treatment for IBD, which is used in Japan (if I recall correctly).

Anyhow, in pubmed, here's a description of the treatment. I note that this description specifically cites this treatment as being aimed at UC, and does not mention CD. And when I comb through pubmed searching by "apheresis Crohn's", the overwhelming majority of the hits seem to also mention this treatment as being aimed at UC. Anyhow, here's one link which cites this treatment for CD:


http://www.ncbi.nlm.nih.gov/pubmed/22449667

So if anyone has heard of this or has a comment about its use for CD or UC, please post. This is the first I've ever heard of it, and it seems as though it might be a somewhat benign treatment option, so it's got me kind of interested to learn more about it.




Gastroenterol Hepatol. 2012 Jan;35(1):22-31. Epub 2011 Dec 12.
[Apheresis in inflammatory bowel disease. a valid option?].
[Article in Spanish]
Cabriada JL.
SourceServicio de Aparato Digestivo, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, España. [email protected]

Abstract
Leukocyte apheresis works by purifying distinct populations of active leukocytes and by modifying inflammatory mediators. Based on their theoretical immunomodulatory effect, these techniques have begun to be used in inflammatory bowel disease. There are two types of devices: granulocytapheresis, which performs selective granulocyte and monocyte absorption, and leukocytapheresis, which carries out non-selective filtration. Conventional treatment regimens consist of between 5 and 10 sessions, normally one session per week, to induce remission. Although the indications for apheresis have not been clearly defined, this technique can be considered a valid option in selected patients with ulcerative colitis, mainly those with corticosteroid-dependent or corticosteroid-refractory disease when other, better-established immunosuppressive or biological treatments have failed. In addition to avoiding the use of corticosteroids, due to its excellent safety profile, apheresis is an attractive option to avoid the risks of immunosuppressive and biological treatments and for use in the pediatric population. The present reviews analyzes the data on the safety and efficacy of apheresis in those patients with inflammatory bowel diseases who could benefit from this technique.

Copyright © 2011 Elsevier España, S.L. All rights reserved.

PMID:22169354[PubMed - in process]

 

[David]

I know it as Leukocytapheresis. I came across it not too long ago and posted a thread in the Ulcerative Colitis forum. It's quite interesting but my personal knowledge of it is limited. I'd love to meet someone who has undergone it and hear a first hand account

Are you thinking of trying it?

 

[Mark in Seattle]

I found a decent little writeup in a book that is featured in a Google book preview.

The book is titled: Clinical Dilemmas in Inflammatory Bowel Disease, and the writeup is on pages 105-107.

Maybe this link might work,

http://books.google.com/books?id=Q5...de&source=gbs_toc_r&cad=4#v=onepage&q&f=false

and then scroll down to page 105.

It seems like it quotes good results for the studies. It also mentions that it's mainly for UC, but it seems like the little study results there are for CD are good. It mentions risks and side effects, which seem kind of benign.

It also mentions cost, at $1,400 per treatment, and from what I understand, 8 treatments are required.

I noted a woman from Sweden on the healingwell.com site who goes by "this to shall pass". She apparently had the procedure (8 treatments I think she said, within 4 weeks), and she claims it put her CD into remission, and I think that was her comment about 3-4 months after the treatment.

I kind of get the impression that maybe there's not a lot of trials since the pharma's probably wouldn't be making big bucks off of it.

I'd be tempted to look into it if there was a trial, but for $12k plus what would likely mean traveling overseas, that's a tall order.