title: Multivariate analysis for factors predicting rapid response of leukocytapheresis in patients with steroid-resistant ulcerative colitis: a multicenter prospective open-label study.
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.
authors.affiliation: Division of Lower Gastroenterology Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Akira
authors.initials: A
authors.lastname: Andoh
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Okawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ito
authors.forename: Ayao
authors.initials: A
authors.lastname: Torii
authors.forename: Syusaku
authors.initials: S
authors.lastname: Yoshikawa
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Nakaoka
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okuyama
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Oshitani
authors.forename: Masakazu
authors.initials: M
authors.lastname: Nishishita
authors.forename: Kenji
authors.initials: K
authors.lastname: Watanabe
authors.forename: Ken
authors.initials: K
authors.lastname: Fukunaga
authors.forename: Kunio
authors.initials: K
authors.lastname: Ohnishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kusaka
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Masaya
authors.initials: M
authors.lastname: Sasaki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tsujikawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Aoki
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kusaka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takeda
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Umehara
authors.forename: Shiro
authors.initials: S
authors.lastname: Nakamura
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Fujiyama
mesh_terms: 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
chemical_list: D005938:Glucocorticoids