Leukocytapheresis (LCAP) in the Management of Chronic Active Ulcerative Colitis—Results of a Randomized Pilot Trial
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Recent studies suggest that leukocytapheresis with Cellsorba is a valuable therapy for ulcerative colitis after failure of conventional treatment. In this study the potential of leukocytapheresis to induce remission in refractory chronic colitis under the conditions of European treatment guidelines was investigated. The therapeutic benefit of leukocytapheresis in the maintenance of remission was additionally elucidated. Twenty patients were treated weekly for 5 weeks. A significant decrease in the activity index was observed. Fourteen patients achieved clinical remission, and mucosal healing was observed endoscopically in six patients. After randomization these 14 patients in remission entered a second period of either monthly leukocytapheresis or no further treatment. In both groups steroids were tapered down. After 6 months, only one patient in the control group remained in remission, in contrast to five of eight patients in the leukocytapheresis group. In conclusion, leukocytapheresis may offer a therapeutic option in the induction and the maintenance of remission in chronic active ulcerative colitis.
KeywordsLeukocytapheresis Inflammatory bowel disease Ulcerative colitis Immunosuppression
The authors wish to thank the apheresis nurses at the Centre for Apheresis, Rostock, for all their efforts and technical assistance during the performace of LCAP treatments. This work was sponsored by Asahi Medical Co., Ltd. (9-1, Kanda Mitoshirocho, Chiyoda-ku, Tokyo 101-8482, Japan), and Asahi Medical GmbH (Arabella Center, Lyoner Str. 44-48, 60528 Frankfurt am Main, Germany).
- 13.Ueki Y, Yamasaki S, Kanamoto Y, Kawazu T, Yano M, Matsumoto K, Miyake S, Tominaga Y, Iwamoto U, Suemitsu J, Matsuno Y, Sizume Y, Takenaka Y, Eguchi K (2000) Evaluation of filtration leucocytapheresis for use in the treatment of patients with rheumatoid arthritis. Rheumatol 39:165–171CrossRefGoogle Scholar
- 15.Hidaka T, Suzuki K, Kawakami M, Okada M, Kataharada K, Shinohara T, Takamizawa-Matsumoto M, Ohsuzu F (2001) Dynamic changes in cytokine levels in serum and synovial fluid following filtration leukocytapheresis therapy in patients with rheumatoid arthritis. J Clin Apher 16:74–81PubMedCrossRefGoogle Scholar
- 17.Kempe K, Tsuda H, Yang K, Yamaji K, Kanai Y, Hashimoto H (2004) Filtration leukocytapheresis therapy in the treatment of rheumatoid arthritis patients resistant to or failed with methotraxate. Ther Apher Dial 197–205Google Scholar