title: Cytapheresis in patients with severe ulcerative colitis after failure of intravenous corticosteroid: a long-term retrospective cohort study.
abstract: OBJECTIVE
  Cytapheresis (CAP) is a novel strategy for ulcerative colitis (UC). However, there is insufficient data on the long-term outcome of UC patients who achieve remission by CAP. This study involved patients with severe UC who refracted to intravenous (iv) corticosteroid.
  
  
  METHODS
  Forty-seven UC patients who had received CAP therapy for the first time within 1 year after UC diagnosis were followed for 36 months. One of the inclusion criteria was a clinical activity index (CAI) of >/=7 points at the end of a 2-week iv course of corticosteroid therapy. CAP therapy consisted of ten sessions over 10 weeks.
  
  
  RESULTS
  CAP induced clinical remission (CAI</=4) in 70.2% patients (33/47). The number of submissions for colectomy was higher for severe UC at entry (CAI>/=12, n=25) than for moderately severe UC at entry (7</=CAI<12, p=15; p<0.02). The cumulative rates of avoiding surgery and relapse were 54.5% and 24.2%, respectively, at 36 months in patients who responded to CAP therapy. This was similar to that of iv cyclosporine reported recently.
  
  
  CONCLUSIONS
  This study suggest that CAP is an effective therapy in patients who are refractory to conventional medications including iv corticosteroid. Increased remission rates should be expected in refractory patients with moderately severe UC.
authors.affiliation: Division of Lower Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Fukunaga
authors.forename: Kazuko
authors.initials: K
authors.lastname: Nagase
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kusaka
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hida
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ohda
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshida
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Tozawa
authors.forename: Koji
authors.initials: K
authors.lastname: Kamikozuru
authors.forename: M
authors.initials: M
authors.lastname: Iimuro
authors.forename: Shiro
authors.initials: S
authors.lastname: Nakamura
authors.forename: Hiroto
authors.initials: H
authors.lastname: Miwa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto