Effective treatment of steroid-naive ulcerative colitis patientsAccording to a research article published in the World Journal of Gastroenterology, the therapeutic utility of LCAP (Leukocytapheresis) for steroid-naïve patient with UC was investigated by Dr. Masatoshi Kudo from Kinki University School of Medicine of Japan. Kudo remarked that the efficacy of LCAP can be forecasted on the assumption of endoscopic findings.

It was found that steroid administration can lead to varying side effects despite the fact that it is considered as a second-line therapy for the induction of remission in ulcerative colitis (UC), if remissions are not attainable by salazosulfapyridine or mesalazine treatment.

From Eurekalert.org:

In 1995, LCAP was introduced for patients with UC. LCAP is a method where the blood is passed though a leukocyte removal filter before being returned to the body. On average, 1.6 × 1010 leukocytes are removed during one session. These leukocytes include granulocytes, lymphocytes and monocytes. Almost 100% of granulocytes and monocytes and 60% of lymphocytes are removed by removal filter. In this study, we found 61.1% of steroid-naive UC patients (11/18) had entered remission eight weeks after the last LCAP session.

Since steroids can induce remission in 45% to 90% of salazosulfapyridine or mesalazine non-responders, it appears that LCAP is as efficacious as steroids as a second-line treatment. Analysis of the endoscopic findings of the patients revealed that while the remission rate of the patients with erosion was extremely high after LCAP; however, that of the patients with geographic ulcers and deep ulcers extremely low. None of the patients experienced any severe adverse effects from LCAP. Given the low rate of adverse events suffered by patients treated with LCAP, we propose that patients with moderately active UC should be treated with LCAP before steroids are considered.

It can thus be concluded that LCAP may prove to be an effective and safe treatment option for steroid-naive UC patients with moderate activity. In addition to that, endoscopic findings are beneficial for predicting the treatment efficacy.