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Multivariate Analysis for Factors Predicting Rapid Response of Leukocytapheresis in Patients With Steroid‐resistant Ulcerative Colitis: A Multicenter Prospective Open‐label Study
Author(s) -
Matsumoto Takayuki,
Andoh Akira,
Okawa Kiyotaka,
Ito Hiroaki,
Torii Ayao,
Yoshikawa Syusaku,
Nakaoka Ryosuke,
Okuyama Yusuke,
Oshitani Nobuhide,
Nishishita Masakazu,
Watanabe Kenji,
Fukunaga Ken,
Ohnishi Kunio,
Kusaka Takeshi,
Yokoyama Yoko,
Sasaki Masaya,
Tsujikawa Tomoyuki,
Aoki Tetsuya,
Kusaka Toshihiro,
Takeda Yasuhiro,
Umehara Yasushi,
Nakamura Shiro,
Fujiyama Yoshihide
Publication year - 2008
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2008.00639.x
Subject(s) - medicine , ulcerative colitis , gastroenterology , prospective cohort study , open label , multicenter study , inflammatory bowel disease , multivariate analysis , disease , clinical trial , randomized controlled trial
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.