Leukocytapheresis (LCAP) in the Management of Chronic Active Ulcerative Colitis—Results of a Randomized Pilot Trial

Abstract

Recent studies suggest that leukocytapheresis with Cellsorba is a valuable therapy for ulcerative colitis after failure of conventional treatment. In this study the potential of leukocytapheresis to induce remission in refractory chronic colitis under the conditions of European treatment guidelines was investigated. The therapeutic benefit of leukocytapheresis in the maintenance of remission was additionally elucidated. Twenty patients were treated weekly for 5 weeks. A significant decrease in the activity index was observed. Fourteen patients achieved clinical remission, and mucosal healing was observed endoscopically in six patients. After randomization these 14 patients in remission entered a second period of either monthly leukocytapheresis or no further treatment. In both groups steroids were tapered down. After 6 months, only one patient in the control group remained in remission, in contrast to five of eight patients in the leukocytapheresis group. In conclusion, leukocytapheresis may offer a therapeutic option in the induction and the maintenance of remission in chronic active ulcerative colitis.

Safety and tolerability of a modified filter‐type device for leukocytapheresis using ACD‐A as anticoagulant in patients with mild to moderately active ulcerative colitis. Results of a pilot study

“…The indication has been treatment of mild to moderate attacks of UC with high response and remission rates, enabling lower steroid dosage [5,6]. One important advantage is the lack of significant adverse events [7], which can sometimes be encountered with potent immunomodulatory or immunosuppressive pharmaceutical compounds such as anti-TNF agents [8] or thiopurine agents [9].…”

Endoscopic findings can predict the efficacy of leukocytapheresis for steroid-naive patients with moderately active ulcerative colitis

“…However, steroid administration can increase susceptibility to infections, diabetes mellitus and osteoporosis. Recently, it was reported that steroidrefractory or steroid-dependent patients with UC can be effectively treated by cytapheresis [7][8][9][10] . To determine whether leukocytapheresis (LCAP) may also be useful with other UC patients, we administered LCAP to 18 steroid-naive UC patients.…”

Cytapheresis in Inflammatory Bowel Diseases: Current Evidence and Perspectives

“…Very recently in a randomized pilot trial, 20 patients with active UC not responding to conventional treatment received Cellsorba apheresis treatment, 1 session/week for 5 consecutive weeks [67]. Of 20 patients, 14 achieved clinical remission and 6/20 patients also achieved endoscopic remission.…”

“…The 14 responder patients were further randomized to receive a monthly apheresis session or no further treatment. After 6 months, 5/8 patients receiving monthly apheresis maintained remission compared to 1/6 in the group with no further treatment [67]. …”