Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
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Original Article

Volume 7, Number 11, November 2015, pages 884-889

Combination Therapy With Adalimumab Plus Intensive Granulocyte and Monocyte Adsorptive Apheresis in Patients With Refractory Ulcerative Colitis


Figure 1.
Figure 1. Changes in the mean full Mayo scores (A) and endoscopic subscore (B) between baseline and 10 weeks in nine cases. No. 4 patient, who received total colectomy, was excluded from this analysis. The data are presented as means ± SE values, and comparisons were made by using a paired t-test. A significance level of 0.01 was used for all statistic tests, and two-tailed tests were applied when appropriate.
Figure 2.
Figure 2. Cumulative remission rate of patients receiving combination therapy of ADA plus intensive GMA for 10 weeks and subsequent maintenance monotherapy of ADA. A Kaplan-Meier plot with a fitted curve of cumulative remission rate over time is shown. The solid circles represent event occurrences and censoring is indicated by the open circles.


Table 1. Baseline Demographic Variables of the 10 Cases With UC Refractory to Medications Including TAC Who Were Selected for This Combination Therapy With ADA Plus Intensive GMA
DemographicNumber of patients
The data are presented as means or median values.
Age (range)57.1 (34 - 85)
Mean disease duration, years (range)8.3 (0.2 - 20)
Disease location (n, %)
  Extensive8 (80)
  Left-sided2 (20)
Concurrent medication (n, %)
  5-ASA10 (100)
  Corticosteroids10 (100)
  TAC2 (20)
Baseline full Mayo scores (mean)9.3
Median CRP levels (range)1.28 (0.03 - 27.9)
Doses of corticosteroids, mg/day (mean)26.5
Corticosteroid-dependent/refractory (n, %)
  Dependent7 (70)
  Refractory3 (30)


Table 2. Clinical Course Over 52 Weeks
No.Age (years)SexDisease locationPretreatedBaselineTreatedAt 10 weeksAt 24 weeksAt 52 weeksClinical course
TAC LORPSL (mg)Full MayoEndo scoresCRP (mg/dL)ADAIntensive GMAFull MayoEndo scoresCRCRP (mg/dL)PSL (mg)p MayoCRP (mg/dL)Full MayoEndo scoresCRCRP (mg/dL)ADA continuedFailed/flare (weeks)AZA (mg)AE
One patient received total colectomy at 4 weeks because of no response to combination therapy of ADA plus intensive GMA. TAC: tacrolimus; LOR: loss of response; PSL: prednisolone; CRP: C-reactive protein; ADA: adalimumab; GMA: granulocyte and monocyte adsorptive apheresis; p Mayo: partial Mayo; CR: clinical remission; failed: failure to achieve clinical remission; AZA: azathioprine; AE: adverse events.
471FExtensive-4012327.9++12 (4 weeks)ope40 (4 weeks)-