A retrospective analysis of the efficacy and safety of infliximab as rescue therapy in acute severe ulcerative colitis

Abstract

SUMMARY BackgroundForty per cent of patients with acute severe ulcerative colitis will not respond to intravenous corticosteroids and require second-line medical therapy or colectomy. A recent controlled trial has suggested that infliximab may be effective as rescue therapy.

Infliximab three-dose induction regimen in severe corticosteroid-refractory ulcerative colitis: Early and late outcome and predictors of colectomy

“…4 Preliminary open label series of severe corticosteroid-refractory UC treated with IFX report a wide range of colectomy rate, starting from 18% up to 75%. [10][11][12][13][14] However, comparison with these studies is flawed by the small number of patients, different inclusion criteria and definitions of steroid failure, variable duration of follow-up and different rescue treatment schedules.…”

“…Open label series with different length follow-up and different IFX dose regimens report an overall colectomy rate ranging from 18% to 75%. [10][11][12][13][14] In a previous study on IIVT-refractory severe UC patients who were treated with IFX as rescue therapy, we reported the results of an Italian open-label study with an overall colectomy rate of 29% after a median follow-up of 23 months. 15 Although in this study there was no predefined IFX infusion regimen and patients received different number of infusions at different time intervals according to clinical judgement, the short-term colectomy rate was significantly higher in patients receiving a single infusion when compared to patients who received two or more infusions.…”

Ulcerative Colitis and Microorganisms

“…Monoclonal antibodies anti-Tumour Necrosis Factor alpha mechanism of action includes the neutralization of both soluble and transmembrane portion of this molecule; also neutralizes Tumour Necrosis Factor alpha-producing (Sandborn, 2010;Smolen, 2011). Monoclonal antibodies anti-Tumour Necrosis Factor alpha were first used in the treatment of Crohn's disease but have been used successfully in severe, unresponsive to treatment Ulcerative Colitis or as rescue therapy (Hoentjen & van Bodegraven, 2009;Lees et al 2007). …”

Long-term results of medical treatment in patients with a severe attack of ulcerative colitis

“…Однако если в целом ИНФ в сочета-нии со стандартной терапией при ЯК позволяет избежать хирургического лечения почти у 90% пациентов в течение 1 года [19], то при ТО ЯК, резистентной к внутривенным ГКС, к хирургическому лечению, несмотря на введения ИНФ, приходится прибегать практически в 1 / 3 случаев [20][21][22]. При этом в одном из рандомизированных испы-таний ИНФ при резистентной к ГКС форме ЯК препарат признан неэффективным [23].…”