Sustained remission after steroids and leukocytapheresis induced response in steroid-dependent ulcerative colitis: results at 1 year.
BACKGROUND
Leukocytapheresis (LAP) could be an alternative treatment for steroid-dependent ulcerative colitis (UC).


OBJECTIVE
To assess the duration of response at 1 year after this treatment.


METHODS
A prospective study in 18 patients with steroid-dependent UC treated with LAP plus steroids after failure or intolerance to immunomodulators. Clinical and endoscopic (Mayo Clinic index) examinations were performed at 1 month after the last apheresis and at 12 months. The clinical, endoscopic remission and the relapse during the 1-year follow-up were evaluated based on standard parameters.


RESULTS
Induction of remission: clinical remission: 10/18 (55%). Partial response: 4. Endoscopic remission: 9 (50%), always accompanied by clinical remission. A significant correlation was observed between clinical remission and endoscopic remission (r(s)=0.894; p< or =0.001). At 1 year: sustained steroid-free clinical remission in 9 (50%), all of whom presented initial endoscopic remission. Remission and relapse before 1 year in 17%. A tendency for sustained remission at 1 year was observed when initial endoscopic remission was achieved.


CONCLUSIONS
Initial remission can be maintained at 1 year in half of the patients without the need for additional steroids. Complete remission and endoscopic mucosal healing is proposed as an objective for achieving a lasting response.
Cabriada
Jose L
JL
Gastroenterology and Hepatology Service, Hospital Galdakao-Usánsolo, Galdakao (Vizcaya), Spain. jcabriada@gmail.com
Ibargoyen
Nora
N
Hernández
Anaiansi
A
Bernal
Antonio
A
Castiella
Agustín
A
D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000628:therapy*; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007937:Leukapheresis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
D005938:Glucocorticoids