Corticosteroid therapy of ulcerative colitis (UC) is associated with frequent adverse side effects and poor quality of life.Recently, adsorptive granulocyte and monocyte/macrophage apheresis has shown efficacy in pati...Corticosteroid therapy of ulcerative colitis (UC) is associated with frequent adverse side effects and poor quality of life.Recently, adsorptive granulocyte and monocyte/macrophage apheresis has shown efficacy in patients with severe steroid refractory UC. The objective of this study was to investigate if, instead of corticosteroids, adsorptive leukocytapheresis has efficacy as the first-line therapy for steroid-naive patients with active UC. Twenty patients, aged 15-49 years, with a meanclinical activity index (CAI) of 8.6 were recruited. Adsorptive leukocytapheresis was done with Adacolumn, which contains cellulose acetate beads as adsorptive carriers for granulocytes and monocytes (Fcγ R and complement receptors expressing leukocytes). Each patient received 6 to 10 leukocyte apheresis sessions of 60min duration, at 2 sessions/week. Efficacy was assessed 1 week after the last session. Post treatment, the mean CAI was 3.0 (P=0.001), and 17 of 20 patients (85% ) were in remission. There were significant falls in C-reactive protein (P= 0.0003), total white cell counts (P=0.003), neutrophils (P=0.0029),and monocytes(P=0.0038), an increase in lymphocytes(P= 0.001), and increases in the blood levels of soluble TNF-α receptors I(P=0.0007) and II(P=0.0045) in the column outflow(blood return to the patients). Further, at 8 months, 60% of patients had maintained their remission. No severe side effectswere reported. In conclusion, adsorptive leukocytapheresis should reduce corticosteroid therapy in patients with moderate UC; cases with early-stage active disease may benefit most.展开更多
文摘Corticosteroid therapy of ulcerative colitis (UC) is associated with frequent adverse side effects and poor quality of life.Recently, adsorptive granulocyte and monocyte/macrophage apheresis has shown efficacy in patients with severe steroid refractory UC. The objective of this study was to investigate if, instead of corticosteroids, adsorptive leukocytapheresis has efficacy as the first-line therapy for steroid-naive patients with active UC. Twenty patients, aged 15-49 years, with a meanclinical activity index (CAI) of 8.6 were recruited. Adsorptive leukocytapheresis was done with Adacolumn, which contains cellulose acetate beads as adsorptive carriers for granulocytes and monocytes (Fcγ R and complement receptors expressing leukocytes). Each patient received 6 to 10 leukocyte apheresis sessions of 60min duration, at 2 sessions/week. Efficacy was assessed 1 week after the last session. Post treatment, the mean CAI was 3.0 (P=0.001), and 17 of 20 patients (85% ) were in remission. There were significant falls in C-reactive protein (P= 0.0003), total white cell counts (P=0.003), neutrophils (P=0.0029),and monocytes(P=0.0038), an increase in lymphocytes(P= 0.001), and increases in the blood levels of soluble TNF-α receptors I(P=0.0007) and II(P=0.0045) in the column outflow(blood return to the patients). Further, at 8 months, 60% of patients had maintained their remission. No severe side effectswere reported. In conclusion, adsorptive leukocytapheresis should reduce corticosteroid therapy in patients with moderate UC; cases with early-stage active disease may benefit most.
