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International Journal of Colorectal Disease

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01-08-2011 | Original Article

The efficacy and safety of selective leukocytapheresis in the treatment of ulcerative colitis: a meta-analysis

Authors: Mingming Zhu, Xitao Xu, Fang Nie, Jinlu Tong, Shudong Xiao, Zhihua Ran

Published in: International Journal of Colorectal Disease | Issue 8/2011

Abstract

Purpose

The use of selective leukocytapheresis for the treatment of ulcerative colitis (UC) has been evaluated in several open and controlled trials, with varying outcomes. A meta-analysis was performed to better assess the efficacy and safety of selective leukocytapheresis as supplemental therapy compared with conventional pharmacotherapy in patients with UC.

Methods

All randomized trials comparing selective leukocytapheresis supplementation with conventional pharmacotherapy were included from electronic databases and reference lists. A meta-analysis that pooled the outcome effects of leukocytapheresis and pharmacotherapy was performed. A fixed effect model or random effect model was selected depending on the heterogeneity test of the trials.

Results

Nine randomized controlled trials met the inclusion criteria contributing a total of 686 participants. Compared with conventional pharmacotherapy, leukocytapheresis supplementation presented a significant benefit in promoting a response rate (OR, 2.88, 95% CI: 1.60–5.18) and remission rate (OR, 2.04; 95% CI, 1.36–3.07) together with significant higher steroid-sparing effects (OR, 10.49; 95% CI, 3.44–31.93) in patients with active moderate-to-severe UC by intention-to-treat analysis. Leukocytapheresis was more effective in maintaining clinical remission for asymptomatic UC patients than conventional therapy (OR, 8.14; 95% CI, 2.22–29.90). The incidence of mild–moderate adverse effects was much less frequent in the leukocytapheresis groups than conventional pharmacotherapy groups (OR, 0.16; 95% CI, 0.04–0.60). Few severe adverse events were observed.

Conclusions

Current data indicate that leukocytapheresis supplementation may be more efficacious on improving response and remission rates and tapering corticosteroid dosage with excellent tolerability and safety than conventional pharmacotherapy in patients with UC. In addition, more high-quality randomized controlled trials are required to confirm the higher efficacy of leukocytapheresis in patients with UC.

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Title: The efficacy and safety of selective leukocytapheresis in the treatment of ulcerative colitis: a meta-analysis
Authors: Mingming Zhu
Xitao Xu
Fang Nie
Jinlu Tong
Shudong Xiao
Zhihua Ran
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 8/2011
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-011-1193-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The efficacy and safety of selective leukocytapheresis in the treatment of ulcerative colitis: a meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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