Refractory Ulcerative Colitis Improved by Scheduled Combination Therapy of Vedolizumab and Granulocyte and Monocyte Adsorptive Apheresis

Masanao Nakamura; Takeshi Yamamura; Keiko Maeda; Tsunaki Sawada; Yasuyuki Mizutani; Eri Ishikawa; Ayako Ohashi; Go Kajikawa; Kazuhiro Furukawa; Eizaburo Ohno; Takashi Honda; Hiroki Kawashima; Masatoshi Ishigami; Mitsuhiro Fujishiro

doi:10.2169/internalmedicine.5302-20

CASE REPORTS

Refractory Ulcerative Colitis Improved by Scheduled Combination Therapy of Vedolizumab and Granulocyte and Monocyte Adsorptive Apheresis

Masanao Nakamura, Takeshi Yamamura, Keiko Maeda, Tsunaki Sawada, Yasuyuki Mizutani, Eri Ishikawa, Ayako Ohashi, Go Kajikawa, Kazuhiro Furukawa, Eizaburo Ohno, Takashi Honda, Hiroki Kawashima, Masatoshi Ishigami, Mitsuhiro Fujishiro

Author information

Masanao Nakamura
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Takeshi Yamamura
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Keiko Maeda
Department of Endoscopy, Nagoya University Hospital, Japan
Tsunaki Sawada
Department of Endoscopy, Nagoya University Hospital, Japan
Yasuyuki Mizutani
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Eri Ishikawa
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Ayako Ohashi
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Go Kajikawa
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Kazuhiro Furukawa
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Eizaburo Ohno
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Takashi Honda
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Hiroki Kawashima
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Masatoshi Ishigami
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan
Mitsuhiro Fujishiro
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan

Keywords: apheresis, clinical remission, ulcerative colitis, vedolizumab

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 23 Pages 3009-3014

DOI https://doi.org/10.2169/internalmedicine.5302-20

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Abstract

Granulocyte and monocyte adsorptive apheresis (GMA) is occasionally introduced as an alternative combination therapy after loss of response to biologics in ulcerative colitis (UC) patients. However, there have been no reports of the concomitant use of vedolizumab (VDZ) and GMA for the initial induction of UC. A 20-year-old man with refractory UC was admitted for recrudescence. VDZ monotherapy had previously been introduced but was ineffective. Therefore, he received scheduled combination of VDZ and GMA and achieved clinical remission. The combination of two different approaches to inhibit the migration of leukocytes into the inflamed tissue led to satisfactory clinical outcomes.

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