Sustained remission after steroids and leukocytapheresis induced response in steroid-dependent ulcerative colitis: results at 1 year.

Abstract

BACKGROUND:

Leukocytapheresis (LAP) could be an alternative treatment for steroid-dependent ulcerative colitis (UC).

AIMS:

To assess the duration of response at 1 year after this treatment.

PATIENTS AND METHODS:

A prospective study in 18 patients with steroid-dependent UC treated with LAP plus steroids after failure or intolerance to immunomodulators. Clinical and endoscopic (Mayo Clinic index) examinations were performed at 1 month after the last apheresis and at 12 months. The clinical, endoscopic remission and the relapse during the 1-year follow-up were evaluated based on standard parameters.

RESULTS:

Induction of remission: clinical remission: 10/18 (55%). Partial response: 4. Endoscopic remission: 9 (50%), always accompanied by clinical remission. A significant correlation was observed between clinical remission and endoscopic remission (r(s)=0.894; p< or =0.001). At 1 year: sustained steroid-free clinical remission in 9 (50%), all of whom presented initial endoscopic remission. Remission and relapse before 1 year in 17%. A tendency for sustained remission at 1 year was observed when initial endoscopic remission was achieved.

CONCLUSIONS:

Initial remission can be maintained at 1 year in half of the patients without the need for additional steroids. Complete remission and endoscopic mucosal healing is proposed as an objective for achieving a lasting response.

• Authors: Jose L Cabriada, Nora Ibargoyen, Anaiansi Hernández, Antonio Bernal, Agustín Castiella
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 42 Issue 6 Pg. 432-5 (Jun 2010) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 19833566 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Glucocorticoids

Topics

• Colitis, Ulcerative (diagnosis, therapy)
• Colonoscopy
• Female
• Follow-Up Studies
• Glucocorticoids (therapeutic use)
• Humans
• Intestinal Mucosa (pathology)
• Leukapheresis (methods)
• Male
• Middle Aged
• Prospective Studies
• Remission Induction
• Time Factors
• Treatment Outcome