Tratamiento de la colitis ulcerosa corticorrefractaria con infliximab

Fernández, Manuel; Díaz, E. García; Romero, Manuel; Jurado, V. Galán; Alonso, Carlos

doi:10.1016/s0210-5705(03)70344-6

Cited by 2 publications

(2 citation statements)

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“…CRP: C-reactive protein difficult in some settings). In such patients, data about infliximab efficacy are contradictory, with response rates varying between 33 and 100% (22)(23)(24)(25)(26)(27)(28)(29)(30). A recent placebo-controlled trial does not support the use of infliximab in this group of patients (29).…”

Section: Discussionmentioning

confidence: 99%

“…En la primera situación, infliximab podría constituir una alternativa a la ciclosporina con la ventaja de una administración más sencilla que no precisa la monitorización de niveles del fármaco (lo que imposibilita el uso de ciclosporina en algunos centros). En este tipo de enfermos los datos de eficacia de infliximab son contradictorios con porcentajes de respuesta descritos que oscilan entre el 33 y el 100% (22)(23)(24)(25)(26)(27)(28)(29)(30) controlado con placebo no apoya el uso de infliximab en este grupo de pacientes (29). Sólo uno de nuestros enfermos recibió infliximab por situación clínica de colitis refractaria a esteroides y el resultado fue óptimo.…”

Section: Discussionunclassified

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Infliximab induces clinical, endoscopic and histological responses in refractory ulcerative colitis

Bermejo

López-Sanromán²,

Hinojosa

et al. 2004

Rev. esp. enferm. dig.

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Background: infliximab is a monoclonal antiTNF-α antibody that has repeatedly shown to be effective in the management of Crohn's disease. However, data are scarce about its efficacy in ulcerative colitis.Aim: to describe the joint experience of three Spanish hospitals in the use of infliximab in patients with active refractory ulcerative colitis.Patients and methods: we present seven cases of ulcerative colitis (6 with chronic active disease despite immunosuppressive therapy, and one with acute steroid-refractory ulcerative colitis) treated with infliximab 5 mg/kg of body weight. Clinical response was evaluated by means of the Clinical Activity Index at 2, 4 and 8 weeks after initial infusion. Biochemical (erythrocyte sedimentation rate and C-reactive protein), endoscopic, and histological changes were also assessed.Results: mean age of patients was 45.8 ± 17 years (range 23-77); 4 were female. No adverse effects were recorded. Inflammatory activity diminished significantly in 6 of 7 patients (85.7%; CI 95%: 42-99%) both from a clinical (p = 0.01) and biochemical (p <0.05) point of view. Five out of six patients (83.3%; 36-99%) with corticosteroid-dependent disease could be successfully weaned off these drugs. Five patients were endoscopicly controlled both before and after therapy, and a positive endoscopic and histological response could be recorded in all of them.Conclusion: infliximab may be an effective and safe therapy for some patients with ulcerative colitis refractory to other forms of therapy, although controlled studies are needed to assess its role in the general management of this disease.

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