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Infliximab as rescue therapy in hospitalized patients with acute ulcerative colitis

A long-term study reported in the latest Alimentary Pharmacology & Therapeutics investigates infliximab as rescue therapy in hospitalized patients with steroid-refractory acute ulcerative colitis.

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Rescue therapy with infliximab has been proven effective in a steroid-refractory attack of ulcerative colitis.

The long-term efficacy is not well described.

Dr Sjöberg and colleagues from Sweden presented a retrospective study of infliximab as rescue therapy in ulcerative colitis.

The researcher team's primary end points were colectomy-free survival at 3 and 12 months.

The team evaluated 211 adult patients hospitalized between 1999 and 2010 received infliximab 5 mg/kg as rescue therapy due to a steroid-refractory, moderate-to-severe attack of ulcerative colitis.

The team's exclusion criteria were duration of current flare for more than 12 weeks, corticosteroid treatment for more than 8 weeks before hospitalization, previous infliximab therapy or Crohn's disease.

Probability of colectomy-free survival at 3 months was 0.7, at 12 months 0.6, at 3 years 0.59, and at 5 years 0.53.

Probability of colectomy-free survival at 3 months was 0.7
Alimentary Pharmacology & Therapeutics

Steroid-free, clinical remission was achieved in 105/211 and 112/209 patients at 3 and 12 months, respectively.

Of 75 colectomies during the first year, 48 were carried out during the first 14 days, 13 on days 15–90 and 14 between 3 and 12 months.

There were 3 deaths during the first 3 months.

Dr Sjöberg's team concluded, "Infliximab is an effective rescue treatment, both short- and long-term, in a steroid-refractory attack of ulcerative colitis."

"Most infliximab failures underwent surgery during the first 14 days, which calls for studies on how to optimise induction treatment with infliximab."

"Serious complications, including mortality, were rare."

Aliment Pharmacol & Ther 2013: 38(4): 377–387
29 July 2013

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