Leukapheresis for inflammatory bowel disease

Current evidence suggests that there are no major safety concerns for the use of leukapheresis for inflammatory bowel disease.

Leukapheresis may be beneficial in carefully selected patients with ulcerative colitis, but the evidence on efficacy is not yet adequate to support its use in these patients without special arrangements for consent and for audit or research as set out in 1.4.

There is inadequate evidence to draw any conclusions about the efficacy of leukapheresis in patients with Crohn's disease and it should only be used in accordance with special arrangements for consent and audit as set out in 1.4.

Clinicians wishing to undertake leukapheresis for inflammatory bowel disease should take the following actions.

• Inform the clinical governance leads in their Trusts.

• Ensure that patients understand the uncertainty about the procedure's efficacy and provide them with clear written information. Use of NICE's information for the public is recommended.

• Audit and review clinical outcomes of all patients having leukapheresis.

Publication of current and future research studies will be useful. NICE may review the procedure upon publication of further evidence.