J Clin Med Res

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

Journal website http://www.jocmr.org

Short Communication

Volume 12, Number 1, January 2020, pages 36-40

Combination Therapy With Tofacitinib Plus Intensive Granulocyte and Monocyte Adsorptive Apheresis as Induction Therapy for Refractory Ulcerative Colitis

Figure 1. Clinical outcomes at baseline and at 10 weeks in seven patients who received combination therapy TOF and intensive GMA. The mean full Mayo scores (a) and endoscopic sub-scores (b) show significant differences between at baseline and 10 weeks (P < 0.01). The mean full Mayo scores decreased from 8.71 ± 0.80 at baseline to 1.57 ± 0.48 at 10 weeks, and the mean endoscopic subscore decreased from 2.4 ± 0.2 at baseline to 0.6 ± 0.2 at 10 weeks. CRP values (c) show no significant difference between at baseline and 10 weeks (P = 0.20). The mean CRP level decreased from 0.71 ± 0.49 mg/dL at baseline to 0.02 ± 0.005 mg/dL at 10 weeks. The values are presented as means ± standard error values and were made by using paired t-test. *P< 0.01. TOF: tofacitinib; GMA: granulocyte and monocyte adsorptive apheresis; CRP: C-reactive protein.

**Table 1.** Baseline Demographic Data of Seven Cases That Received Combination Therapy With TOF and Intensive GMA for Refractory UC
Demography
The data are presented as means. TOF: tofacitinib; GMA: granulocyte and monocyte adsorptive apheresis; UC: ulcerative colitis; TNF: tumor necrosis factor; CRP: C-reactive protein.
Male/female (N)	2/5
Age (years)	53.3
Mean disease duration (years)	16.1
Location of lesions (N)
Extensive	3
Left-sided	4
Severity (N)
Moderate/severe	6/1
Concomitant medications for UC (N)
Corticosteroids/budesonide	6
Mesalamine	7
Azathioprine	1
Prior use of anti-TNF-α antibodies (N)	4
Full Mayo score at baseline	8.71
Endoscopic sub-score at baseline	2.4
CRP at baseline (mg/dL)	0.71

Table 1. Baseline Demographic Data of Seven Cases That Received Combination Therapy With TOF and Intensive GMA for Refractory UC

Demography

The data are presented as means. TOF: tofacitinib; GMA: granulocyte and monocyte adsorptive apheresis; UC: ulcerative colitis; TNF: tumor necrosis factor; CRP: C-reactive protein.

Male/female (N)

2/5

Age (years)

53.3

Mean disease duration (years)

16.1

Location of lesions (N)

Extensive

Left-sided

Severity (N)

Moderate/severe

6/1

Concomitant medications for UC (N)

Corticosteroids/budesonide

Mesalamine

Azathioprine

Prior use of anti-TNF-α antibodies (N)

Full Mayo score at baseline

8.71

Endoscopic sub-score at baseline

2.4

CRP at baseline (mg/dL)

0.71

**Table 2.** Clinical Course Through 10 Weeks
No.	Age	Sex	Disease duration (years)	Disease location	Pretreated	At baseline	Treated	At 10 weeks
PSL: prednisolone; Bude: budesonide; CRP: C-reactive protein; ADA: adalimumab; IFX: infliximab; TOF: tofacitinib; GMA: granulocyte and monocyte adsorptive apheresis; CR: clinical remission; AZA: azathioprine.
1	70	M	10	Left-sided	IFX	40	12	3	3.56	+	+	0	0	+	0.04	0
2	40	M	4	Extensive	ADA	40	10	2	0.99	+	+	1	1	+	0.04	0
3	45	F	29	Left-sided	IFX	0	6	3	0.03	+	+	3	1	-	0.03	0
4	58	F	22	Extensive		3	7	2	0.04	+	+	3	0	-	0.03	0
5	64	F	32	Left-sided		5	9	3	0.16	+	+	2	1	+	0.01	0
6	50	F	6	Left-sided	ADA, AZA	Bude 2	7	2	0.04	+	+	2	1	+	0.01	0
7	46	F	10	Extensive		20	10	2	0.2	+	+	0	0	+	0.01	0

Table 2. Clinical Course Through 10 Weeks

No.

Age

Sex

Disease duration (years)

Disease location

Pretreated

At baseline

Treated

At 10 weeks

Previous treatment

PSL (mg)

Full Mayo

Endo scores

CRP (mg/dL)

TOF

Intensive GMA

Full Mayo

Endo scores

CRP (mg/dL)

PSL (mg)

PSL: prednisolone; Bude: budesonide; CRP: C-reactive protein; ADA: adalimumab; IFX: infliximab; TOF: tofacitinib; GMA: granulocyte and monocyte adsorptive apheresis; CR: clinical remission; AZA: azathioprine.

Left-sided

IFX

3.56

0.04

Extensive

ADA

0.99

0.04

Left-sided

IFX

0.03

Extensive

0.04

0.03

Left-sided

0.16

0.01

Left-sided

ADA, AZA

Bude 2

0.04

0.01

Extensive

0.2

0.01