A Meta-Analysis Of The Efficacy And Safety Of Granulocyte/Monocyte Apheresis Therapy In The Treatment Of Ulcerative Colitis

Objective:Systematically evaluate the effectiveness and safety of Granulocyte/monocyte apheresis(GMA)for ulcerative colitis(UC).Methods:A randomized controlled trial on the treatment of UC with GMA was publicly published in Pub Med,Cochrane Library,Embase,and Web of science databases until October 30,2022.The literature was screened and extracted in strict accordance with the specified inclusion and exclusion criteria.Two researchers independently evaluated the quality of the included literature using the risk bias assessment tool in the Cochrane 5.1.0manual.The meta-analysis was conducted using the Review Manager 5.1 software.The outcome indicators clinical response induction,clinical remission induction,clinical remission maintenance,and adverse reaction incidence.Trial Sequential Analysis(TSA)was performed on outcome indicators using TSA 0.9.5.10 Beta software.Results:A total of 1226 subjects were included in 14 articles,including 645 in the experimental group and 581 in the control group.The clinical response induction rate of GMA treatment to active UC was significantly higher than that of conventional treatment[OR=1.71,95% CI(1.18,2.47),P=0.004],and the clinical remission induction rate of GMA treatment to active UC was significantly higher than that of conventional treatment[OR=2.09,95% CI(1.33,3.29),P=0.001].The clinical remission maintenance rate of UC treated with GMA was significantly higher than that of conventional treatment[OR=2.37,95% CI(1.49,3.77),P=0.0003].There was no significant difference in the incidence of adverse reactions between UC patients receiving GMA treatment and conventional treatment [OR=0.26,95% CI(0.04,1.59),P<0.14].TAS shows that the clinical remission maintenance in the treatment of UC with GMA is worthy of recognition.Conclusions:The clinical response induction rate,clinical remission induction,and clinical remission maintenance rate of GMA treatment for UC are higher than those of conventional treatment.TSA analysis of the clinical remission maintenance effect of GMA on UC deserves recognition,and the clinical response induction and clinical remission induction effect of GMA on UC still need further verification.There was no significant difference in the incidence of adverse reactions between GMA and conventional treatment for UC.