Document Detail


Successful treatment of steroid refractory active ulcerative colitis with natural interferon-beta--an open long-term trial.
MedLine Citation:
PMID:  18080224     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: In some steroid refractory patients with active ulcerative colitis (UC), treatment with immunosuppressive agents, such as cyclosporin, azathioprine or 6-mercaptopurin is effective. However, there are patients who fail to respond to these treatment options or who cannot tolerate them. Application of natural interferon-beta (nIFN-beta) may offer an alternative. Following our positive results with nIFN-beta in a previously published open-labeled study, the present study was designed as an extension with the hypothesis that administration of higher dosage of nIFN-beta (1.0 vs. 0.5 MIU) could result in fewer relapse events. PATIENTS AND METHODS: 46 steroid refractory patients with active UC and a mean clinical activity index (CAI) of 13.2 +/- 3.7 (range 9-23) were treated with nIFN-beta in addition to existing basic medication (5-ASA/SASP plus corticosteroids). During an induction period of eight weeks, 18 patients (group A) received 0.5 MIU nIFN-beta daily and 28 patients (group B), 1.0 MIU nIFN-beta daily intravenously as a bolus injection. Patients who achieved complete remission (decrease of CAI to < or = 4) during the induction period received maintenance therapy with nIFN-beta at the same dose level three times a week and corticosteroids were withdrawn. Remissions and maintenance of remissions were evaluated. RESULTS: In both groups, a comparable number of complete remissions occurred during the induction period: in 16 / 18 patients (89 %) in group A and in 24 / 28 patients (86 %) in group B. Duration of maintenance treatment was 60.0 +/- 90.0 weeks in group A and 52.7 +/- 9.6 weeks in group B. Under this treatment, relapses (increase of CAI to > or = 6) occurred in 5 / 16 patients (31 %) vs. 1 / 24 patients (4 %) (p < or = 0.05). Hence, regarding maintaining remissions, the 1.0 MIU group outscored the 0.5 MIU group. Apart from known flu-like side effects, the therapy was well tolerated by all patients in both groups. CONCLUSION: nIFN-beta may be a safe and effective alternative to induce and maintain remissions in patients with steroid refractory active UC. To validate the presented results, its effect has to be investigated in a randomized, placebo-controlled dose-finding trial.
Authors:
E Musch; T Andus; M Malek; A Chrissafidou; M Schulz
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Zeitschrift für Gastroenterologie     Volume:  45     ISSN:  0044-2771     ISO Abbreviation:  Z Gastroenterol     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-14     Completed Date:  2008-03-31     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0033370     Medline TA:  Z Gastroenterol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1235-40     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Marienhospital Bottrop, Germany. eugen.musch@mhb-bottrop.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenal Cortex Hormones / administration & dosage
Adult
Aged
Colitis, Ulcerative / diagnosis,  drug therapy*
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Resistance
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Immunologic Factors / administration & dosage*,  adverse effects
Infusions, Intravenous
Interferon-beta / administration & dosage*,  adverse effects
Long-Term Care
Male
Mesalamine / administration & dosage
Middle Aged
Recurrence / prevention & control
Sigmoidoscopy
Sulfasalazine / administration & dosage
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Immunologic Factors; 599-79-1/Sulfasalazine; 77238-31-4/Interferon-beta; 89-57-6/Mesalamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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