Efficacy of cytapheresis in patients with ulcerative colitis showing insufficient or lost response to biologic therapy

Table 3 Efficacy of combination therapy with cytapheresis and biologics in inflammatory bowel disease patients showing insufficient response or loss of response to biologics

Ref.	Study type	Biologics to which insufficient response or LOR was shown	Number of patients	Methods of combination therapy	Regimen of CAP	Rate of remission	Rate of response	Rate of steroid-free remission	Rate of AE (%)
González Carro et al[38], 2006	Case report	IFX (LOR)	CD 1	IFX + GMA	GMA 1 session/8 wk, 12 mo	100%
Fukunaga et al[39], 2010	Case report	IFX (LOR)	CD 1	IFX + GMA	GMA 1 sessions/wk, 3 consecutive weeks × 3 courses and maintenance therapy	100%			0/1 (0%)
Sono et al[40], 2012	Prospective study	IFX (LOR)	CD 15	IFX + GMA	GMA 1 session/wk, 5 consecutive wk		46.7%; a fall in CDAI by more than 15%
Ozeki et al[41], 2012	Case report	(1) IFX (failure); (2) ADA (failure); (3) Steroid refractory and etc.	(1) CD 1; (2) CD 1; and (3) CD 3	ADA + GMA	GMA 2 sessions/wk, 5 consecutive wk	100%			0/5 (0%)
Yokoyama et al[42], 2014	Prospective observational study	IFX	UC 42	IFX + LCAP	LCAP 5-10 sessions (mean 8.4), intensive LCAP was performed in > 70% of Pts	69.0% (Pts concomitantly treated with IFX)
Yokoyama et al[43], 2018	Case report	IFX (LOR)	UC 2; CD 1	IFX + GMA	GMA 1 session/wk, 3 consecutive wk or more	UC 100%, CD 100%
Scrivo et al[44], 2018	Case report	VDZ (primary nonresponse to VDZ; Previous LOR to IFX; Primary non-response to ADA)	UC 1	VDZ + GMA	GMA 1 session/wk,5 wk			100%	0/1 (0%)
Sáez-González et al[45], 2018	Case report	VDZ (primary nonresponse to VDZ; Primary nonresponse to ADA and IFX)	UC 1	VDZ + GMA	GMA 2 sessions/wk, 5 wk + 14 monthly maintenance sessions			100%
Tanida et al[46], 2018	Retrospective study	(1) IFX (LOR); (2) ADA (LOR); (3) Steroid refractory	(1) CD 1; (2) CD 1; and (3) CD 1	UST + GMA	GMA: 2 sessions/wk, for 5 consecutive wk	100%		50%	0/3 (0%)
Rodríguez-Lago et al[47], 2019	Retrospective multicenter study	Anti-TNF therapy (IFX 23, ADA 18, GLM 6); Primary nonresponse 49%, LOR 51%	UC 47	Anti-TNF therapy + GMA	GMA 1 sessions/wk 45%, 2 sessions/wk 55%; 5-10 sessions 51%, > 10 sessions 19% (median of 10 sessions)		32%	9%	2/47 (4%)
Rodríguez-Lago et al[48], 2019	Retrospective multicentre pilot study	VDZ (primary nonresponse 25%, secondary LOR 75%); All Pts had previously received anti-TNF agents (IFX 88%, ADA 50%, GLM 38%)	UC 8	VDZ + GMA	GMA: 5-38 sessions (median 15), biweekly 75%, weekly 25%; maintenance GMA 75%, monthly 38%, every 2 wk 25%		Partial Mayo score decreased (P = 0.01)	38%	0/8 (0%)
Nakamura et al[49], 2020	Case report	VDZ (primary nonresponse to VDZ; Serious allergy to IFX)	UC 1	VDZ + GMA	semiweekly GMA, 4 wk	100%
Tanida et al[50], 2020	Retrospective study	(1) IFX(LOR); (2) ADA (LOR); (3) Steroid refractory or dependent	(1) UC 2; (2) UC 2; and (3) UC 3	TOF + GMA	GMA: 2 sessions/wk, total 10 sessions			75%	3/7 (43%)
Yokoyama et al[51], 2020	Preliminary study	IFX (LOR)	UC 7; CD 7	IFX + GMA	1 or 2 sessions/wk, for 5 consecutive wk, Pts who did not achieved remission by week 8 underwent another GMA (1 session/wk, 5 consecutive wk)	All IBD 64.3%, UC 42.9%, CD 85.7%			0/14 (0%)

LOR: Loss of response; CAP: Cytapheresis; CD: Crohn’s disease; GMA: Granulocyte and monocyte adsorptive apheresis; UC: Ulcerative colitis; LCAP: Leukocytapheresis; AE: Adverse events; IFX: Infliximab; ADA: Adalimumab; Pts: Patients; VED: Vedolizumab; UST: Ustekinumab; TNF-α: Tumor necrosis factor-α; GLM: Golimumab; TOF: Tofacitinib; Intensive LCAP: Defined as performing ≥ 4 leukocytapheresis within the first 2 wk.