Predictive factors of efficacy of leukocytapheresis for steroid-resistant ulcerative colitis patients

Abstract

Background The effectiveness of leukocytapheresis against ulcerative colitis has been reported. However, the efficacy of this therapy for steroid-resistant ulcerative colitis patients has hardly been examined. Aims The aims of this study are to evaluate the efficacy of leukocytapheresis for steroid-resistant ulcerative colitis patients and to identify clinical factors that predict the efficacy of this therapy for these patients. Methods Clinical factors of 71 steroid-resistant ulcerative colitis patients who underwent leukocytapheresis analysed. Results Of those analysed, 53 (75%) patients showed an initial response to leukocytapheresis. Among cases with initial response, however, only 19 (27%) patients maintained remission for more than 6 months. Steroid-dependent course (Odds ratio = 5.53, 95% confidence interval; 1.24–24.73) and a high C-reactive protein degree (Odds ratio = 1.6, confidence interval; 1.09–2.35) were predictors of initial response to leukocytapheresis. Rapid response, which means remission induction within three leukocytapheresis sessions, was the only predictor of maintenance of remission for more than 6 months after successful leukocytapheresis therapy (odds ratio = 8.01, confidence interval; 1.08–59.37). Conclusions Leukocytapheresis was effective for steroid-resistant ulcerative colitis patients. However, relapse was frequently observed within short periods after the initial response to this therapy. Patients without a rapid response should be treated with alternative or additional therapies.