Leukocyte adsorptive apheresis for the treatment of active ulcerative colitis: A prospective, uncontrolled, pilot study  Hiroyuki Hanai, Fumitoshi Watanabe, Ken Takeuchi, Takayuki Iida, Masami Yamada, Yasushi Iwaoka, Abby Saniabadi, Isao Matsushita, Yoshihiko Sato, Kotaro Tozawa, Hajime Arai, Takahisa Furuta, Ken Sugimoto, Ingvar Bjarnason  Clinical Gastroenterology and Hepatology  Volume 1, Issue 1, Pages 28-35 (January 2003) DOI: 10.1053/jcgh.2003.50005 Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 1 Study design and selection of patients for GM adsorptive aphresis therapy. Intravenous prednisolone (PSL) indicates intravenous prednisolone (60–80 mg/day); oral prednisolone (40–60 mg/day). The dose of mesalamine was 2.25 g/day, and the dose of sulfasalazine was 3 g/day. During leukocyte adsorptive therapy, prednisolone was tapered or discontinued in patients who improved. Clinical Gastroenterology and Hepatology 2003 1, 28-35DOI: (10.1053/jcgh.2003.50005) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 2 Colonoscopy photographs of transverse colon showing typical response to leukocyte adsorptive apheresis therapy with Adacolumn in corticosteroid refractory patients. (A) Photograph taken at entry to Adacolumn therapy shows multiple inflammatory pseudopolyps together with longitudinal ulcers. (B) Photograph taken at week 6 shows improvements in both pseudopolyps and ulcers, and (C) photograph taken at week 12 shows remission of polyps and ulcers. Clinical Gastroenterology and Hepatology 2003 1, 28-35DOI: (10.1053/jcgh.2003.50005) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 3 UC CAI score and UC DAI score in 31 corticosteroid refractory and 8 corticosteroid naïve patients at entry and week 12 after start of GM reduction therapy with Adacolumn. Clinical Gastroenterology and Hepatology 2003 1, 28-35DOI: (10.1053/jcgh.2003.50005) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 4 Response rate versus number of leukocyte adsorptive sessions in 8 corticosteroid naive and 31 corticosteroid refractory patients. In refractory patients 5 cycles of adsorptive apheresis were sufficient to induce remission in 7 of 8 patients, whereas 25 of 31 refractory patients were in remission after 10 cycles (week 12). Clinical Gastroenterology and Hepatology 2003 1, 28-35DOI: (10.1053/jcgh.2003.50005) Copyright © 2003 American Gastroenterological Association Terms and Conditions

Fig. 5 Remission maintenance vs time for 33 of 39 patients who achieved remission during or shortly after leukocyte adsorptive therapy. At 12 months, 26 of 33 patients had maintained their remission. Clinical Gastroenterology and Hepatology 2003 1, 28-35DOI: (10.1053/jcgh.2003.50005) Copyright © 2003 American Gastroenterological Association Terms and Conditions