Multivariate analysis for factors predicting rapid response of leukocytapheresis in patients with steroid-resistant ulcerative colitis: A multicenter prospective open-label study

Takayuki Matsumoto*, Akira Andoh, Kiyotaka Okawa, Hiroaki Ito, Ayao Torii, Syusaku Yoshikawa, Ryosuke Nakaoka, Yusuke Okuyama, Nobuhide Oshitani, Masakazu Nishishita, Kenji Watanabe, Ken Fukunaga, Kunio Ohnishi, Takeshi Kusaka, Yoko Yokoyama, Masaya Sasaki, Tomoyuki Tsujikawa, Tetsuya Aoki, Toshihiro Kusaka, Yasuhiro TakedaYasushi Umehara, Shiro Nakamura, Yoshihide Fujiyama

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Leukocytapheresis (LCAP) has been advocated as a treatment for moderate to severe active ulcerative colitis (UC) in Japan. To clarify the predictive factors for a rapid response to LCAP treatment, we conducted a multicenter prospective open-label study. A total of 105 patients with UC were analyzed. LCAP was performed using a Cellsorba EX column once a week for 5-10 sessions. The response was evaluated by the clinical activity index (CAI). When the CAI score decreased to less than half the pretreatment value or to less than 5 points within 3 weeks, the patient was considered to be a rapid responder. The average CAI significantly decreased from 11.7 to 4.2 (P < 0.01). Seventy-four percent of the patients responded to the therapy, and 53% of these patients were rapid responders. The following significant factors correlated with the rapid LCAP response: (i) steroid resistance (P < 0.05), (ii) severe disease indicated by a CAI score greater than 11 (P = 0.05), (iii) disease duration of less than 1 year (P < 0.05), and (iv) C-reactive protein levels before treatment (P < 0.01). These results suggest that the early initiation of LCAP is beneficial in patients with steroid-resistant UC.

Original languageEnglish
Pages (from-to)484-490
Number of pages7
JournalTherapeutic Apheresis and Dialysis
Volume12
Issue number6
DOIs
StatePublished - 2008/12

Keywords

  • Clinical activity index
  • Leukocytapheresis
  • Predictive factors
  • Ulcerative colitis

ASJC Scopus subject areas

  • Hematology
  • Nephrology

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