A large-scale, prospective, observational study of leukocytapheresis for ulcerative colitis: Treatment outcomes of 847 patients in clinical practice

Yoko Yokoyama, Katsuyoshi Matsuoka, Taku Kobayashi, Koji Sawada, Tateshi Fujiyoshi, Takafumi Ando, Yoshifumi Ohnishi, Tetsuya Ishida, Masashi Oka, Masahiro Yamada, Takashi Nakamura, Tomoko Ino, Toyoko Numata, Hirofumi Aoki, Jun ichi Sakou, Masahiro Kusada, Tomoki Maekawa, Toshifumi Hibi

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25 Citations (Scopus)

Abstract

Background and aims: Leukocytapheresis is an extracorporeal therapy for ulcerative colitis. However, no large-scale study on leukocytapheresis has been reported. This large-scale, prospective, observational study aimed to evaluate the treatment outcomes of leukocytapheresis for active ulcerative colitis in clinical practice. Methods: Patients with active ulcerative colitis treated with leukocytapheresis using a Cellsorba E column between May 2010 and December 2012 were enrolled from 116 medical facilities in Japan. Results: A total of 847 patients were enrolled, and 623 were available for efficacy analysis. Out of 847 patients, 80.3% of the patients had moderate to severe disease activity, and 67.6% were steroid refractory. As concomitant medications, 5-aminosalicylic acids, corticosteroids, and thiopurines were administered to 94.8%, 63.8%, and 32.8% of the patients, respectively. In addition, infliximab and tacrolimus were concomitantly used in 5.8% and 12.3%, respectively. Intensive leukocytapheresis (≥ 4 leukocytapheresis sessions within the first 2. weeks) was used in > 70% of the patients. Adverse events were seen in 10.3% (87/847), which were severe in only 5 patients (0.6%). Any concomitant medications did not increase the incidence of adverse events. Intensive leukocytapheresis was as safe as the conventional weekly procedure. The overall clinical remission rate was 68.9% (429/623), and the mucosal healing rate was 62.5% (145/232). Clinical remission was achieved more frequently and rapidly in the intensive group than in the weekly group. Conclusions: This large-scale study indicates that leukocytapheresis, including intensive procedure, is a safe and effective therapeutic option for active ulcerative colitis.

Original languageEnglish
Pages (from-to)981-991
Number of pages11
JournalJournal of Crohn's and Colitis
Volume8
Issue number9
DOIs
Publication statusPublished - 2014 Sep 1

Keywords

  • Large-scale observational study
  • Leukocytapheresis
  • Safety
  • Treatment outcomes
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

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