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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 14, 2008; 14(34): 5316-5321
Published online Sep 14, 2008. doi: 10.3748/wjg.14.5316
Endoscopic findings can predict the efficacy of leukocytapheresis for steroid-naive patients with moderately active ulcerative colitis
Yasushi Umehara, Masatoshi Kudo, Masanori Kawasaki
Yasushi Umehara, Masatoshi Kudo, Masanori Kawasaki, Division of Gastroenterology and Hepatology, Department of Internal Medicine Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama 589-8511, Japan
Author contributions: Umehara Y, Kudo M and Kawasaki M contributed equally to this work; Umehara Y and Kudo M desined research; Umehara Y and Kawasaki M performed research; Umehara Y and Kudo M contributed new reagents/analytic tools; Umehara Y and Kudo M analyzed data and Umehara Y wrote the paper.
Correspondence to: Masatoshi Kudo, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama 589-8511, Japan. m-kudo@med.kindai.ac.jp
Telephone: +81-723-660221-3525 Fax: +81-723-672880
Received: June 21, 2008
Revised: August 11, 2008
Accepted: August 18, 2008
Published online: September 14, 2008
Abstract

AIM: To investigate the therapeutic usefulness of leukocytapheresis (LCAP; Cellsoba) in steroid-naive patients with moderately active ulcerative colitis (UC).

METHODS: Eighteen steroid-naive patients with moderately active UC received one LCAP session every week for five consecutive weeks.

RESULTS: The remission rate 8 weeks after the last LCAP session was 61.1% (11/18). All three patients with deep ulcers showed worsening after LCAP. For the remaining 15 patients, who had erosions or geographic ulcers, the average clinical activity index (CAI) score dropped significantly from 9.4 to 3.8 eight weeks after the last LCAP session (t = 4.89, P = 0.001). The average C-reactive protein (CRP) levels before and after LCAP were 1.2 mg/dL and 1.0 mg/dL, respectively. Of the patients with erosions, geographic ulcers, and deep ulcers, 100% (9/9), 33.3% (2/6), and 0% (0/3) were in remission 8 weeks after the last LCAP session, respectively (χ2 = 7.65, P < 0.005). Forty-eight weeks after the last LCAP session, the remission rates for patients with erosions and geographic ulcers were 44.4% (4/9) and 16.7% (1/6), respectively. Only one patient suffered a mild adverse event after LCAP (nausea).

CONCLUSION: LCAP is a useful and safe therapy for steroid-naive UC patients with moderate disease activity. Moreover, the efficacy of the treatment can be predicted on the basis of endoscopic findings.

Keywords: Ulcerative colitis; Steroid-naive; Leukocytapheresis; Efficacy; Endoscopic findings