1127 Infliximab in Steroid-Dependent Ulcerative Colitis: Efficacy and Predictors of Clinical and Endoscopic Remission

Armuzzi, Alessandro; Pugliese, Daniela; Danese, Silvio; Rizzo, Gianluca; Felice, Carla; Marzo, Manuela; Andrisani, Gianluca; Fiorino, Gionata; Vitis, I. De; Papa, Alfredo; Rapaccini, Gian Ludovico; Guidi, Luisa

doi:10.1016/s0016-5085(12)60770-7

Cited by 12 publications

(25 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This observation suggests that in a subgroup of patients in whom ADA shows a rapid impact on symptoms and systemic inflammation, a better outcome can be expected. As recently reported for moderate to severe steroid-dependent UC patients treated with infliximab [27], the observation that previous exposure to immunomodulators has a negative impact on long-term remission rates suggests that a more severe and refractory disease is less likely to benefit from ongoing conservative management. Nevertheless, previous infliximab exposure did not affect the long-term remission rate in our series: a possible explanation could be the low number of infliximab-naïve patients in this case series, who were mostly treated with ADA because of concomitant active spondyloarthritis.…”

Section: Discussionmentioning

confidence: 76%

Adalimumab in active ulcerative colitis: A “real-life” observational study

Armuzzi¹,

Biancone²,

Daperno³

et al. 2013

Digestive and Liver Disease

Self Cite

View full text Add to dashboard Cite

a b s t r a c tBackground and aims: The effectiveness of adalimumab in the treatment of ulcerative colitis is under debate. Although controlled trials have shown that adalimumab is significantly better than placebo, the absolute clinical benefit is modest. We report data on the effectiveness of adalimumab in a cohort of ulcerative colitis patients treated in 22 Italian centres. Methods: All patients with active disease treated with adalimumab were retrospectively reviewed. Coprimary endpoints were clinical remission at weeks 4, 12, 24 and 54. Secondary endpoints were sustained clinical remission, steroid discontinuation, endoscopic remission and need for colectomy. Results: Eighty-eight patients were included. Most patients had received previous infliximab treatment. Clinical remission rates were 17%, 28.4%, 36.4% and 43.2% at 4, 12, 24 and 54 weeks respectively. Twentytwo patients required colectomy. Clinical remission and low C-reactive protein at week 12 predicted clinical remission at week 54 (OR 4.17, 95% CI 2.36-19.44; OR 2.63, 95% CI 2.32-14.94, respectively). Previous immunosuppressant use was associated with a lower probability of clinical remission at week 54 (OR 0.67, and with a higher rate of colectomy (HR 9.7, 95% CI 1.46-9.07). Conclusion: In this large "real-life" experience adalimumab appears effective in patients with otherwise medically refractory ulcerative colitis. Patients achieving early remission can expect a better long-term outcome.

show abstract

Section: Discussionmentioning

confidence: 76%

Adalimumab in active ulcerative colitis: A “real-life” observational study

Armuzzi¹,

Biancone²,

Daperno³

et al. 2013

Digestive and Liver Disease

Self Cite

View full text Add to dashboard Cite

show abstract

“…5 In the past decade, several real-life, open-label cohort studies have provided more data on the efficacy and safety of IFX in patients with refractory UC. [6][7][8][9] Short-term clinical response, short-term normalization of C-reactive protein level (CRP), and short-term mucosal healing were among the predictors of colectomy-free survival. 7,8,10,11 In contrast, an increased baseline CRP level, a shorter disease duration before IFX, and previous treatment with intravenous cyclosporine have been associated with a higher colectomy risk.…”

mentioning

confidence: 99%

“…[6][7][8][9] Short-term clinical response, short-term normalization of C-reactive protein level (CRP), and short-term mucosal healing were among the predictors of colectomy-free survival. 7,8,10,11 In contrast, an increased baseline CRP level, a shorter disease duration before IFX, and previous treatment with intravenous cyclosporine have been associated with a higher colectomy risk. 7,9 In a Canadian trial, detectable IFX serum levels were associated with higher clinical remission rates, higher endoscopic improvement rates, and lower colectomy rates, but no firm conclusions could be drawn on their predictive value.…”

mentioning

confidence: 99%

A Panel to Predict Long-term Outcome of Infliximab Therapy for Patients With Ulcerative Colitis

Arias

Casteele

Vermeire

et al. 2015

Clinical Gastroenterology and Hepatology

162

124

View full text Add to dashboard Cite

“…In contrast, low(er) concentrations have been demonstrated to be associated with the formation of antidrug antibodies (ADAs). Serum trough IFX concentrations at steady-state between 3 and 7 lg/ml have been related to improved clinical outcomes [9,138,[162][163][164][165][166][167][168][169][170].…”

Section: Pharmacokinetic and Pharmacodynamic Considerationsmentioning

confidence: 99%