BACKGROUND: Several small, prospective, open studies suggest that leukocytapheresis might be efficient in patients with steroid-dependent ulcerative colitis (UC). AIM: To evaluate the short- and long-term effectiveness of leukocytapheresis for the management of steroid-dependent UC in clinical practice. METHODS: A Web-based, nationwide database specifically designed to record the efficacy and safety data of leukocytapheresis therapy in UC was available from September 2007 in Spain. Clinical data were collected at treatment baseline, 1 month after the last apheresis session (initial efficacy), and 6 and 12 months thereafter (long-term efficacy). Remission was defined as a Mayo Clinic index ≤2 together with complete steroid withdrawal and response as a decrease of ≥3 from the baseline score. RESULTS: A total of 142 steroid-dependent UC patients were included in the registry, most of them treated with the Adacolumn™ system. In 69% of patients thiopurine therapy failed to achieve steroid-free clinical remission. Initial clinical remission was obtained in 37% of cases. The initial corticosteroid dose, the number and frequency of apheresis sessions, or the previous failure of thiopurines and/or infliximab did not influence the initial remission rate, but a greater decrease in CRP levels was associated with a higher probability to obtain initial remission. At 6 and 12 months, 41 and 36% of patients were in clinical remission, respectively. Only one serious adverse effect was recorded. CONCLUSIONS: In clinical practice, apheresis allows long-term steroid-free clinical remission in up to one third of steroid-dependent UC patients, even in those with prior failure of thiopurines.
BACKGROUND: Several small, prospective, open studies suggest that leukocytapheresis might be efficient in patients with steroid-dependent ulcerative colitis (UC). AIM: To evaluate the short- and long-term effectiveness of leukocytapheresis for the management of steroid-dependent UC in clinical practice. METHODS: A Web-based, nationwide database specifically designed to record the efficacy and safety data of leukocytapheresis therapy in UC was available from September 2007 in Spain. Clinical data were collected at treatment baseline, 1 month after the last apheresis session (initial efficacy), and 6 and 12 months thereafter (long-term efficacy). Remission was defined as a Mayo Clinic index ≤2 together with complete steroid withdrawal and response as a decrease of ≥3 from the baseline score. RESULTS: A total of 142 steroid-dependent UC patients were included in the registry, most of them treated with the Adacolumn™ system. In 69% of patientsthiopurine therapy failed to achieve steroid-free clinical remission. Initial clinical remission was obtained in 37% of cases. The initial corticosteroid dose, the number and frequency of apheresis sessions, or the previous failure of thiopurines and/or infliximab did not influence the initial remission rate, but a greater decrease in CRP levels was associated with a higher probability to obtain initial remission. At 6 and 12 months, 41 and 36% of patients were in clinical remission, respectively. Only one serious adverse effect was recorded. CONCLUSIONS: In clinical practice, apheresis allows long-term steroid-free clinical remission in up to one third of steroid-dependent UC patients, even in those with prior failure of thiopurines.
Authors: E F Stange; S P L Travis; S Vermeire; W Reinisch; K Geboes; A Barakauskiene; R Feakins; J F Fléjou; H Herfarth; D W Hommes; L Kupcinskas; P L Lakatos; G J Mantzaris; S Schreiber; V Villanacci; B F Warren Journal: J Crohns Colitis Date: 2008-01-18 Impact factor: 9.071
Authors: J L Cabriada; E Doménech; F Gomollón; P González-Carro; V González-Lara; J Hinojosa; C E Jiménez-López; P Nos; A Obrador; J Panès; C Saro; V Varea; R Lafuente; M Guilera Journal: Gastroenterol Hepatol Date: 2006-02 Impact factor: 2.102
Authors: Wolfgang Kruis; Axel Dignass; Elisabeth Steinhagen-Thiessen; Julia Morgenstern; Joachim Mössner; Stephan Schreiber; Maurizio Vecchi; Alberto Malesci; Max Reinshagen; Robert Löfberg Journal: World J Gastroenterol Date: 2005-11-28 Impact factor: 5.742
Authors: Bruce E Sands; William J Sandborn; Brian Feagan; Robert Löfberg; Toshifumi Hibi; Tao Wang; Lisa-Marie Gustofson; Cindy J Wong; Margaret K Vandervoort; Stephen Hanauer Journal: Gastroenterology Date: 2008-04-25 Impact factor: 22.682
Authors: Tryggve Ljung; Ole Østergaard Thomsen; Morten Vatn; Per Karlén; Lars Norman Karlsen; Curt Tysk; Stefan U Nilsson; Anders Kilander; Rolf Gillberg; Olof Grip; Stefan Lindgren; Ragnar Befrits; Robert Löfberg Journal: Scand J Gastroenterol Date: 2007-02 Impact factor: 2.423