Document Detail


Efficacy of infliximab in acute severe ulcerative colitis: a single-centre experience.
MedLine Citation:
PMID:  23467174     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To suggest infliximab (IFX) is effective for acute severe ulcerative colitis, from real-life clinical practice.
METHODS: All patients receiving IFX for the treatment of acute severe ulcerative colitis in a single centre were included. Data were extracted from clinical records in order to assess response to IFX therapy. The primary endpoint was colectomy-free survival, and secondary outcomes included glucocorticosteroid-free remission and safety, which was evaluated by recording deaths and adverse events. Demographic and clinical characteristics of those who underwent colectomy and those who were colectomy-free, both at discharge from their index admission, and during follow-up after an initial response to IFX were compared.
RESULTS: Forty-four patients (16 females, mean age 36 years) received IFX between May 2006 and January 2012 for acute severe ulcerative colitis. The median duration of follow-up post-first infusion was 396 d (interquartile range = 173-828 d). There were 21 (47.7%) patients with < 1 year of follow-up, 10 (22.7%) with 1 years to 2 years of follow-up, and 13 (29.5%) with > 2 years of follow-up post-first infusion of IFX. Overall, 35 (79.5%) responded to IFX, avoiding colectomy during their index admission, 29 (65.9%) were colectomy-free at last point of follow-up (median follow-up 396 d), and 25 (56.8%) were in glucocorticosteroid-free remission at end of follow-up. There was one death from post-operative sepsis, 20 d after a single IFX infusion. Colectomy rates were generally lower among those "bridging" to thiopurine. Of 18 patients "bridged" to thiopurine therapy, 17 (94.4%) were colectomy-free, and 15 (83.3%) were in glucocorticosteroid-free remission at study end. No predictors of response were identified.
CONCLUSION: IFX is effective for acute severe ulcerative colitis in real-life clinical practice. Two-thirds of patients avoided colectomy, and more than 50% were in glucocorticosteroid-free remission.
Authors:
Stephen J Halpin; P John Hamlin; Daniel P Greer; Lisa Warren; Alexander C Ford
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  19     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-03-07     Completed Date:  2013-12-06     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  1091-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anti-Inflammatory Agents / adverse effects,  therapeutic use*
Antibodies, Monoclonal / adverse effects,  therapeutic use*
Chi-Square Distribution
Colectomy
Colitis, Ulcerative / diagnosis,  drug therapy*
England
Female
Glucocorticoids / therapeutic use
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Remission Induction
Severity of Illness Index
Time Factors
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/Glucocorticoids; 0/infliximab
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