Document Detail


Infliximab or Cyclosporine for Acute Severe Ulcerative Colitis: A retrospective analysis.
MedLine Citation:
PMID:  22098019     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background and Aim Medical treatment of steroid-refractory Ulcerative Colitis is limited to either cyclosporine or infliximab. Studies comparing cyclosporine with either placebo or intravenous methylprednisone showed promise for cyclosporine, but associated with significant toxicity. There is conflicting, but increasingly positive evidence for using infliximab. There are no studies directly comparing these two treatments. Our aim is to compare the outcomes of patients with steroid-refractory Ulcerative Colitis treated with either intravenous cyclosporine or infliximab. Methods A retrospective review of inpatients with steroid-refractory Ulcerative Colitis, treated with either intravenous cyclosporine or infliximab, at Waitemata District Health Board, between January 2001 and February 2010. The primary endpoints were time to colectomy, and colectomy rates at 3 and 12 months. Secondary endpoints were time to discharge from initiation of treatment, steroid dependence at 12 months, and reported adverse events. Results The total study population was 38, with 19 in the infliximab group. Follow up to 12 months was complete in all patients. At 3 months, the colectomy rate was 63% for cyclosporine, compared to 21% (p = 0.0094). By 12 months the rate was 68% and 37% for cyclosporine and infliximab respectively (p = 0.06). Patients in the cyclosporine group required an additional 5 days in hospital (p = 0.0086). Steroid dependence at 12 months was 50% for cyclosporine versus 25% for infliximab (p = 0.36). Cyclosporine caused more adverse events (p = 0.17). Conclusions Infliximab improved clinical outcomes compared to the previous use of intravenous cyclosporine in patients admitted with steroid-refractory acute severe Ulcerative Colitis.
Authors:
Kathryn E Dean; Joanna Hikaka; John T Huakau; Russell S Walmsley
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-18
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  -     ISSN:  1440-1746     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Affiliation:
North Shore Hospital Shakespeare Rd Takapuna New Zealand.
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