A multicenter, retrospective, observational study of the clinical outcomes and risk factors for relapse of ulcerative colitis at 1 year after leukocytapheresis

Background Extracorporeal leukocytapheresis (LCAP) is effective for inducing remission of ulcerative colitis (UC). This retrospective observational study aimed to evaluate the clinical outcome at 1 year and identify risk factors for relapse of UC after LCAP. Methods Patients with active UC treated w...

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Bibliographic Details
Published in:Journal of gastroenterology 2018-03, Vol.53 (3), p.387-396
Main Authors: Kobayashi, Taku, Matsuoka, Katsuyoshi, Yokoyama, Yoko, Nakamura, Takashi, Ino, Tomoko, Numata, Toyoko, Shibata, Hiroshi, Aoki, Hirofumi, Matsuno, Yoshihiro, Hibi, Toshifumi
Format: Article
Language:English
Subjects:
Abdominal Surgery
Colorectal Surgery
Corticosteroids
Diseases
Gastroenterology
Hepatology
Induction therapy
Inflammatory bowel disease
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Observational studies
Original Article―Alimentary Tract
Original ―Alimentary Tract
Patient outcomes
Relapse
Remission
Risk factors
Surgical Oncology
Ulcerative colitis
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Summary:Background Extracorporeal leukocytapheresis (LCAP) is effective for inducing remission of ulcerative colitis (UC). This retrospective observational study aimed to evaluate the clinical outcome at 1 year and identify risk factors for relapse of UC after LCAP. Methods Patients with active UC treated with LCAP between 2010 and 2012 were enrolled from 54 medical facilities in Japan. Clinical data evaluated at 1 year after the last LCAP session included the incidence of relapse, 1-year cumulative relapse-free rate, risk factors for relapse, and history of re-induction treatment following relapse. Relapse was defined by the addition of treatment to induce remission. The primary endpoint was the 1-year cumulative relapse-free rate. Secondary endpoints were risk factors for relapse and outcomes of re-induction treatment after relapse. Results For 314 patients, the 1-year cumulative relapse-free rate was 63.6%. Following LCAP, a Lichtiger clinical activity index (CAI) of 3 or 4 and high leukocyte count (cut-off value: 7790/mm 3 ) were associated with a greater risk of relapse. Intensive LCAP (≥4 sessions within the first 2 weeks) was associated with favorable long-term outcomes in corticosteroid-refractory patients. The response rate was 85.1% among 30 patients who required re-treatment with LCAP. Conclusions The majority of patients (>60%) with UC treated with LCAP achieved clinical remission within 1 year and remained relapse-free. A higher Lichtiger CAI and leukocyte count following LCAP were risk factors for relapse. Re-induction therapy with LCAP was effective for relapse of UC.
ISSN:0944-1174
1435-5922
DOI:10.1007/s00535-017-1356-8