Long-term prognosis of patients with ulcerative colitis treated with cytapheresis therapy

Tetsuro Takayama, Takanori Kanai, Katsuyoshi Matsuoka, Susumu Okamoto, Tomohisa Sujino, Yohei Mikami, Tadakazu Hisamatsu, Tomoharu Yajima, Yasushi Iwao, Haruhiko Ogata, Toshifumi Hibi

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Abstract

Background: Although accumulating studies in Japan show that cytapheresis (CAP) therapy is safe and effective for the induction of remission of moderate or severe ulcerative colitis (UC), the long-term prognosis of UC patients treated with CAP is unknown. The aim of this study was to determine the long-term prognosis of UC patients treated with CAP. Methods: Ninety patients treated previously with CAP and followed for more than 3. years were evaluated. The rates of operation, readmission, and use or dose-up of corticosteroid were analyzed as long-term prognosis. Results: Following the first course of CAP treatment, 64% of patients showed clinical improvement (> 4-point decrease in the clinical activity index (CAI)), and 49% of patients achieved clinical remission (CAI ≤ 4). Longer disease duration and lower age at the first CAP treatment correlated significantly with the therapeutic effects of CAP (p= 0.003 and 0.035, respectively). The rates of operation and readmission were significantly lower in patients who showed previous clinical effects of CAP than in those who did not respond to CAP. The rates of operation and readmission were also significantly lower in patients whose treatment was combined with immunomodulators after the initiation of CAP than in patients who did not use immunomodulators. Importantly, the second course of CAP was also effective in most of the patients who showed a clinical response to the first CAP. Conclusions: Patients who achieve remission after the first CAP therapy may have a good long-term prognosis and a good response to a second CAP therapy even after relapse.

Original languageEnglish
JournalJournal of Crohn's and Colitis
Volume7
Issue number2
DOIs
Publication statusPublished - 2013 Mar 1

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Cytapheresis
Ulcerative Colitis
Therapeutics
Immunologic Factors
Remission Induction

Keywords

  • Cytapheresis therapy
  • Inflammatory bowel disease
  • Long-term prognosis
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

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Long-term prognosis of patients with ulcerative colitis treated with cytapheresis therapy. / Takayama, Tetsuro; Kanai, Takanori; Matsuoka, Katsuyoshi; Okamoto, Susumu; Sujino, Tomohisa; Mikami, Yohei; Hisamatsu, Tadakazu; Yajima, Tomoharu; Iwao, Yasushi; Ogata, Haruhiko; Hibi, Toshifumi.

In: Journal of Crohn's and Colitis, Vol. 7, No. 2, 01.03.2013.

Research output: Contribution to journalArticle

Takayama, Tetsuro ; Kanai, Takanori ; Matsuoka, Katsuyoshi ; Okamoto, Susumu ; Sujino, Tomohisa ; Mikami, Yohei ; Hisamatsu, Tadakazu ; Yajima, Tomoharu ; Iwao, Yasushi ; Ogata, Haruhiko ; Hibi, Toshifumi. / Long-term prognosis of patients with ulcerative colitis treated with cytapheresis therapy. In: Journal of Crohn's and Colitis. 2013 ; Vol. 7, No. 2.
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abstract = "Background: Although accumulating studies in Japan show that cytapheresis (CAP) therapy is safe and effective for the induction of remission of moderate or severe ulcerative colitis (UC), the long-term prognosis of UC patients treated with CAP is unknown. The aim of this study was to determine the long-term prognosis of UC patients treated with CAP. Methods: Ninety patients treated previously with CAP and followed for more than 3. years were evaluated. The rates of operation, readmission, and use or dose-up of corticosteroid were analyzed as long-term prognosis. Results: Following the first course of CAP treatment, 64{\%} of patients showed clinical improvement (> 4-point decrease in the clinical activity index (CAI)), and 49{\%} of patients achieved clinical remission (CAI ≤ 4). Longer disease duration and lower age at the first CAP treatment correlated significantly with the therapeutic effects of CAP (p= 0.003 and 0.035, respectively). The rates of operation and readmission were significantly lower in patients who showed previous clinical effects of CAP than in those who did not respond to CAP. The rates of operation and readmission were also significantly lower in patients whose treatment was combined with immunomodulators after the initiation of CAP than in patients who did not use immunomodulators. Importantly, the second course of CAP was also effective in most of the patients who showed a clinical response to the first CAP. Conclusions: Patients who achieve remission after the first CAP therapy may have a good long-term prognosis and a good response to a second CAP therapy even after relapse.",
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AU - Matsuoka, Katsuyoshi

AU - Okamoto, Susumu

AU - Sujino, Tomohisa

AU - Mikami, Yohei

AU - Hisamatsu, Tadakazu

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AU - Iwao, Yasushi

AU - Ogata, Haruhiko

AU - Hibi, Toshifumi

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