Opinion Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2021; 27(10): 908-918
Published online Mar 14, 2021. doi: 10.3748/wjg.v27.i10.908
Use of granulocyte/monocytapheresis in ulcerative colitis: A practical review from a European perspective
Eugeni Domènech, Joan-Ramon Grífols, Ayesha Akbar, Axel U Dignass
Eugeni Domènech, Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona 08916, Catalonia, Spain
Eugeni Domènech, Department of Medicine, Universitat Autònoma de Barcelona, Badalona 08916, Catalonia, Spain
Eugeni Domènech, Centro de Investigaciones Biomédicas en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Badalona 08916, Catalonia, Spain
Joan-Ramon Grífols, Blood and Tissue Bank, Hospital Universitari Germans Trias i Pujol, Badalona 08916, Catalonia, Spain
Ayesha Akbar, IBD Unit, St. Mark’s Hospital and Academic Institute, London HA1 3UJ, United Kingdom
Axel U Dignass, Department of Medicine I, Agaplesion Markus Hospital, Goethe-University, Frankfurt am Main 60431, Germany
Author contributions: Domènech E conceived the idea of the manuscript; all the authors were involved in reviewing the literature and drafting the manuscript.
Conflict-of-interest statement: Domènech E has served as a speaker or has received research or education funding or advisory fees from Samsung, MSD, AbbVie, Takeda, Kern Pharma, Pfizer, Janssen, Celgene, Adacyte Therapeutics, Roche, Otsuka Pharmaceuticals, Ferring, Shire Pharmaceuticals, Tillots, ThermoFisher, Grifols, Gebro, and Gilead. Akbar A has received speaker fees or advisory fees from Takeda, Dr Falk, Abbvie, Janssen, Otsuka Pharmaceuticals, Adacyte therapeutics and MSD. Dignass AU has received research support or acted as a principal investigator for Abbvie, Dr. Falk Pharma, Celgene/BMS, Gilead/Galapagos, Janssen, Otsuka and Takeda; he has acted as a consultant for AbbVie, Amgen, Boehringer Ingelheim, Celgene/BMS, Celltrion, Dr Falk Pharma, Ferring, Fresenius Kabi, Janssen, MSD, Otsuka, Pfizer, Roche, Takeda, Tillotts, Pharmacosmos and Vifor; and has participated in speaker bureaus for AbbVie, Falk Foundation, Ferring, Janssen, Med Update, MSD, Otsuka, Pfizer, Roche, Takeda, Tillotts, and Vifor.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eugeni Domènech, MD, PhD, Chief Physician, Professor, Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Badalona 08916, Catalonia, Spain. eugenidomenech@gmail.com
Received: December 12, 2020
Peer-review started: December 12, 2020
First decision: December 27, 2020
Revised: January 3, 2021
Accepted: February 11, 2021
Article in press: February 11, 2021
Published online: March 14, 2021
Processing time: 88 Days and 15.3 Hours
Core Tip

Core Tip: Approximately 30%-40% of patients with ulcerative colitis will require immunosuppressive therapies, including immunomodulators and biological agents. Unfortunately, none of these therapies achieve more than 40% of steroid-free clinical remission in the middle term; moreover, most immunosuppressive therapies increase the risk of infections and some malignancies, raising the unmet need for therapeutic alternatives in ulcerative colitis. Granulocyte/monocytapheresis (GMA) remains the only therapy targeting neutrophils, the hallmark of pathology in ulcerative colitis. GMA has proven its efficacy in different clinical scenarios and shows an excellent and unique safety profile.