Multivariate analysis for factors predicting rapid response of leukocytapheresis in patients with steroid-resistant ulcerative colitis: a multicenter prospective open-label study.
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.
Matsumoto
Takayuki
T
Division of Lower Gastroenterology Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
Andoh
Akira
A
Okawa
Kiyotaka
K
Ito
Hiroaki
H
Torii
Ayao
A
Yoshikawa
Syusaku
S
Nakaoka
Ryosuke
R
Okuyama
Yusuke
Y
Oshitani
Nobuhide
N
Nishishita
Masakazu
M
Watanabe
Kenji
K
Fukunaga
Ken
K
Ohnishi
Kunio
K
Kusaka
Takeshi
T
Yokoyama
Yoko
Y
Sasaki
Masaya
M
Tsujikawa
Tomoyuki
T
Aoki
Tetsuya
T
Kusaka
Toshihiro
T
Takeda
Yasuhiro
Y
Umehara
Yasushi
Y
Nakamura
Shiro
S
Fujiyama
Yoshihide
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000628:therapy*; D004351:Drug Resistance; D005260:Female; D005544:Forecasting; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007937:Leukapheresis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D005938:Glucocorticoids