Multicenter prospective study for clinical and endoscopic efficacies of leukocytapheresis therapy in patients with ulcerative colitis. (April 2013)

• Record Type: Journal Article
• Authors: Okuyama, Yusuke; Andoh, Akira; Nishishita, Masakazu; Fukunaga, Ken; Kamikozuru, Koji; Yokoyama, Yoko; Ueno, Yoshitaka; Tanaka, Shinji; Kuge, Hiroyuki; Yoshikawa, Syusaku; Sugahara, Atsushi; Anami, Emi; Munetomo, Yoshinori; Watanabe, Chiyuki; Fujiyama, Yoshihide; Matsumoto, Takayuki
• Is Part Of: Scandinavian journal of gastroenterology. Volume 48:Number 4(2013)
• Page Start: 412
• Page End: 418
• Publication Date: 2013-04
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.3109/00365521.2012.763175
• Languages: English
• ISSNs: 0036-5521

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Objective. </italic> </bold>This study aimed to assess the efficacy and tolerability of leukocytapheresis (LCAP) and to investigate predictive factors for mucosal healing and a sustained clinical response in steroid-free and steroid-refractory patients with ulcerative colitis (UC). <bold><italic>Material and methods. </italic></bold>Thirty-one steroid-free or steroid-refractory patients with active UC were enrolled. Five or ten consecutive sessions of LCAP were performed in each patient. The efficacy and tolerability was then evaluated at weeks 3 and 6. Endoscopic examination was performed at week 6 to evaluate the mucosal healing, and the sustained cumulative response rate was evaluated at 12 months. <bold><italic>Results. </italic></bold>At week 6, the mean Mayo clinical activity score had decreased significantly from 8.0 to 4.6 in the steroid-free patients and from 8.3 to 3.9 in the steroid-refractory patients. Rachmilewitz's endoscopic index had also decreased significantly from 9.1 to 6.1 in the steroid-free patients and from 10.0 to 5.7 in the steroid-refractory patients. Forty-seven percent of the steroid-free patients and 33% of the steroid-refractory patients achieved mucosal healing. The peripheral platelet counts had decreased significantly at weeks 3 and 6 in the mucosal healing group, compared with the non-mucosal healing group. The patients with a more than 15% platelet reduction had a significantly higher cumulative response rate, compared with the patients without a platelet reduction (<italic>p</italic> = 0.015). <bold><italic>Conclusions. </italic></bold>LCAP is beneficial for the induction of mucosal healing in steroid-free and steroid-refractory patients with UC. The degree of platelet reduction during LCAP might be a predictive marker for mucosal healing and a sustained clinical response.</p> </abstract>