Document Detail


Predictive factors of clinical response in steroid-refractory ulcerative colitis treated with granulocyte-monocyte apheresis.
MedLine Citation:
PMID:  21528055     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis (GMA).
METHODS: Sixty-nine ulcerative colitis patients (39 F, 30 M) dependent upon/refractory to steroids were treated with GMA. Steroid dependency, clinical activity index (CAI), C reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), values at baseline, use of immunosuppressant, duration of disease, and age and extent of disease were considered for statistical analysis as predictive factors of clinical response. Univariate and multivariate logistic regression models were used.
RESULTS: In the univariate analysis, CAI (P = 0.039) and ESR (P = 0.017) levels at baseline were singled out as predictive of clinical remission. In the multivariate analysis steroid dependency [Odds ratio (OR) = 0.390, 95% Confidence interval (CI): 0.176-0.865, Wald 5.361, P = 0.0160] and low CAI levels at baseline (4 < CAI < 7) (OR = 0.770, 95% CI: 0.425-1.394, Wald 3.747, P = 0.028) proved to be effective as factors predicting clinical response.
CONCLUSION: GMA may be a valid therapeutic option for steroid-dependent ulcerative colitis patients with mild-moderate disease and its clinical efficacy seems to persist for 12 mo.
Authors:
Valeria D'Ovidio; Donatella Meo; Angelo Viscido; Giampaolo Bresci; Piero Vernia; Renzo Caprilli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  17     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-29     Completed Date:  2011-08-09     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  1831-5     Citation Subset:  IM    
Affiliation:
Department of Clinical Sciences, Gastrointestinal Unit, Policlinico Umberto I, University of Rome, La Sapienza, Viale del Policlinico 155, Rome 00161, Italy. Italy. vale_do@yahoo.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Component Removal*
Colitis, Ulcerative / therapy*
Drug Resistance*
Female
Granulocytes / cytology,  metabolism*
Humans
Male
Middle Aged
Monocytes / cytology,  metabolism*
Steroids / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Steroids
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