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Wednesday 26, Aug 2009

  Effective treatment of steroid-naive ulcerative colitis patients

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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.

Tuesday 28, Jul 2009

  Treating Ulcerative Colitis patients

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Treating Ulcerative Colitis patientsUlcerative colitis patients are primarily treated with salazosulfapyridine or mesalazine treatment. Steroids act as a second line therapy for the induction until remission in ulcerative colitis if the first line of treatment fails. However, steroids use can have its side effects.

A research was conducted in Japan by Dr. Masatoshi Kudo from Kinki University School of Medicine. They investigated an alternative treatment for steroid-naive patients with ulcerative colitis. LCAP or leukocytapharesis is a method where the blood is passed through a filter to remove leukocytes before finally returning it inside the body. LCAP was introduced to patients in 1995. Furthermore, they assessed whether the efficacy of LCAP can be predicted on the basis of endoscopic findings.

Results of the study showed that on average, 1.6 x 1010 leukocytes are removed during one session. It included granulocytes, lymphocytes and monocytes. Eleven out of eighteen patients with ulcerative colitis or approximately 61% had entered remission eight weeks after LCAP treatment. Steroids on the other hand can induce remission in 45% to 90% of patients who are non-responsive to salazosulfapyridine or mesalazine treatment. None of the patients treated with LCAP experienced any severe adverse effects from the treatment.

They concluded that LCAP is as efficacious as steroids as a second line of treatment. Patients with moderately active colitis should be treated with LCAP before steroids are considered due to its low incidence of adverse effects.