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We read the article by Sands et al1 with interest. The efficacy of granulocyte/monocyte apheresis (GMA) in inflammatory bowel disease (IBD) is controversial, with previous studies mainly conducted in Japan, involving small numbers of patients, often without sham controls.2–4 The authors should, therefore, be congratulated for performing a large, randomised, double-blind, sham-controlled study of GMA in moderate to severely active Crohn's disease in a Western population.
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