Granulocyte-monocyte apheresis (GMA) is an emerging therapeutic option in active 
course of ulcerative colitis (UC). Appropriate GMA dose, including total number, 
frequency, and duration of the individual GMA session, is a matter of debate. It 
was the aim of the present study to evaluate the efficacy of a dose-intensified 
GMA regimen in patients with moderately to severely active UC. A prospective 
open-label, single-center study was performed in 10 patients with active UC 
(Rachmilewitz Clinical Activity Index [CAI] ≥ 8 points; Rachmilewitz Endoscopic 
Index ≥ 7 points). Patients had failed to improve after treatment with steroids 
and/or immunomodulators. GMA was performed twice weekly for 2 h to a maximum of 
10 sessions. In each GMA session, the adsorber was changed after 1 h of 
treatment time. Four patients achieved remission with a CAI ≤ 4 points. Three 
patients had a response with an improvement of CAI of ≥3 points. Three patients 
showed no benefit from GMA. The quality of life score determined by the 
inflammatory bowel disease questionnaire-Deutschland increased by 26 points in 
median. First and second filters had similar efficiency in granulocyte and 
monocyte adsorption. No major adverse effects were observed. Dose-intensified 
GMA as reported in this study provided an encouraging short-term response rate 
of 70% in patients with moderately to severely active UC not responding to 
standard steroid or immunomodulator therapy. Although all patients relapsed not 
later than 16 weeks, GMA might be useful to reduce steroid and immunomodulator 
usage, or to delay surgery in this patient group.