title: Predictive factors of clinical response in steroid-refractory ulcerative colitis treated with granulocyte-monocyte apheresis.
abstract: OBJECTIVE
  To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis (GMA).
  
  
  METHODS
  Sixty-nine ulcerative colitis patients (39 F, 30 M) dependent upon/refractory to steroids were treated with GMA. Steroid dependency, clinical activity index (CAI), C reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), values at baseline, use of immunosuppressant, duration of disease, and age and extent of disease were considered for statistical analysis as predictive factors of clinical response. Univariate and multivariate logistic regression models were used.
  
  
  RESULTS
  In the univariate analysis, CAI (P = 0.039) and ESR (P = 0.017) levels at baseline were singled out as predictive of clinical remission. In the multivariate analysis steroid dependency [Odds ratio (OR) = 0.390, 95% Confidence interval (CI): 0.176-0.865, Wald 5.361, P = 0.0160] and low CAI levels at baseline (4 < CAI < 7) (OR = 0.770, 95% CI: 0.425-1.394, Wald 3.747, P = 0.028) proved to be effective as factors predicting clinical response.
  
  
  CONCLUSIONS
  GMA may be a valid therapeutic option for steroid-dependent ulcerative colitis patients with mild-moderate disease and its clinical efficacy seems to persist for 12 mo.
authors.affiliation: Department of Clinical Sciences, Gastrointestinal Unit, Policlinico Umberto I, University of Rome, La Sapienza, Viale del Policlinico 155, Rome 00161, Italy. Italy. vale_do@yahoo.it
authors.forename: Valeria
authors.initials: V
authors.lastname: D'Ovidio
authors.forename: Donatella
authors.initials: D
authors.lastname: Meo
authors.forename: Angelo
authors.initials: A
authors.lastname: Viscido
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Bresci
authors.forename: Piero
authors.initials: P
authors.lastname: Vernia
authors.forename: Renzo
authors.initials: R
authors.lastname: Caprilli
mesh_terms: D000328:Adult; D000368:Aged; D001781:Blood Component Removal; D003093:Colitis, Ulcerative / Q000628:therapy*; D004351:Drug Resistance; D005260:Female; D006098:Granulocytes / Q000166:cytology / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology / Q000378:metabolism*; D013256:Steroids / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013256:Steroids