Evaluation Of Selective Leukocyte Removal Therapy For The Treatment Of Inflammatory Bowel Disease: A Systematic Review And Meta-analysis Of Randomized Controlled Studies

Background Sometimes the efficacy of conventional therapies for patients with inflammatory bowel disease is unsatisfactory,so new treatments are necessary.Numerous articles have been reported that selective Leukocyte removal therapy is an effective therapeutic.Therefore,we aim to systematically analyze and assess the efficacy of it via a meta-analysisMethodsA literature search of the Pubmed,Embase and Cochrane Library databases was performed to identify the matching studies.The improving response rates,remission induction,and remission maintenance rates were compared,in studies comparing Leukocyte removal therapy vs.conventional therapy.Results19 articles met the inclusion criteria.For ulcerative colitis,significant differences were observed in the response,remission induction and maintenance rates between the Leukocyte removal therapy and the conventional treatment(P ? 0.05).Sub-group analysis revealed that granulocyte and monocyte/macrophage adsorptive apheresis significantly improved the response remission induction,and remission maintenance rates(P ? 0.05),while leukocytapheresis didn’t have any significant effect(P = 0.13).The pooled response and remission induction rates weren’t significantly different between granulocyte and monocyte/macrophage adsorptive apheresis and leukocytapheresis(P > 0.05).For Crohn’s disease,granulocyte and monocyte/macrophage adsorptive apheresis didn’t have an effect on any of the measured outcomes,however this result is inconclusive as it is was based on limited data.Conclusion Leukocyte removal therapy is an effective treatment for ulcerative colitis patients,independent to the type of apheresis used.However,for Crohn’s disease patients no conclusions can be drawn and more prospective high-quality randomized controlled trials are required.