Multivariate Analysis for Factors Predicting Rapid Response of Leukocytapheresis in Patients With Steroid-resistant Ulcerative Colitis: A Multicenter Prospective Open-label Study

被引：22

作者：

Matsumoto, Takayuki ^{[1
]}

Andoh, Akira ^{[2
]}

Okawa, Kiyotaka ^{[3
]}

Ito, Hiroaki ^{[4
]}

Torii, Ayao ^{[8
]}

Yoshikawa, Syusaku ^{[10
]}

Nakaoka, Ryosuke ^{[5
]}

Okuyama, Yusuke ^{[9
]}

Oshitani, Nobuhide ^{[6
]}

Nishishita, Masakazu ^{[7
]}

Watanabe, Kenji ^{[6
]}

Fukunaga, Ken ^{[1
]}

Ohnishi, Kunio ^{[1
]}

Kusaka, Takeshi ^{[1
]}

Yokoyama, Yoko ^{[1
]}

Sasaki, Masaya ^{[2
]}

Tsujikawa, Tomoyuki ^{[2
]}

Aoki, Tetsuya ^{[3
]}

Kusaka, Toshihiro ^{[8
]}

Takeda, Yasuhiro ^{[8
]}

Umehara, Yasushi ^{[5
]}

Nakamura, Shiro ^{[6
]}

Fujiyama, Yoshihide ^{[2
]}

机构：

[1] Hyogo Coll Med, Div Lower Gastroenterol, Dept Internal Med, Nishinomiya, Hyogo 6638501, Japan

[2] Shiga Univ Med Sci, Dept Med, Shiga, Japan

[3] Osaka City Gen Hosp, Dept Gastroenterol, Osaka, Japan

[4] Kitano Hosp, Dept Med, Osaka, Japan

[5] Kinki Univ, Sch Med, Div Gastroenterol & Hepatol, Osaka 589, Japan

[6] Osaka City Univ, Grad Sch Med, Dept Gastroenterol, Osaka 558, Japan

[7] Nishishita Hosp Gastroenterol, Osaka, Japan

[8] Kyoto Katsura Hosp, Dept Gastroenterol, Kyoto, Japan

[9] Kyoto First Red Cross Hosp, Dept Gastroenterol, Kyoto, Japan

[10] Kenseikai Nara Coloproctol Ctr, Dept Coloproctol, Nara, Japan

来源：

THERAPEUTIC APHERESIS AND DIALYSIS | 2008年 / 12卷 / 06期

关键词：

Clinical activity index; Leukocytapheresis; Predictive factors; Ulcerative colitis;

D O I：

10.1111/j.1744-9987.2008.00639.x

中图分类号：

R5 [内科学];

学科分类号：

1002 [临床医学]; 100201 [内科学];

摘要：

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.

引用

页码：484 / 490

页数：7

共 38 条

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