Infliximab in severe ulcerative colitis: short-term results of different infusion regimens and long-term follow-up

Autor:	Angelo Viscido, M. Marrollo, Cosimo Prantera, Vito Annese, Marco Daperno, Alessandro Armuzzi, Gabriele Riegler, R. Sostegni, Anna Kohn, Antonio Gasbarrini, Gianmichele Meucci, Ambrogio Orlando, Livia Biancone, S. Peralta, Maria Cappello
Rok vydání:	2007
Předmět:	medicine.medical_specialty Hepatology Long term follow up business.industry medicine.medical_treatment Gastroenterology medicine.disease Ulcerative colitis Infliximab Surgery Refractory Rescue therapy medicine Pharmacology (medical) In patient Colitis business Colectomy medicine.drug
Zdroj:	Alimentary Pharmacology & Therapeutics. 26:747-756
ISSN:	1365-2036 0269-2813
DOI:	10.1111/j.1365-2036.2007.03415.x
Popis:	Background Severe ulcerative colitis is a life-threatening disorder, despite i.v. glucocorticoids treatment. Infliximab has been proposed as a safe rescue therapy. Aim To evaluate short- and long-term effectiveness and safety of infliximab in severe refractory ulcerative colitis. Methods Eighty-three patients with severe ulcerative colitis (i.v. glucocorticoids treatment-refractory) were treated with infliximab in 10 Italian Gastroenterology Units. Patients underwent one or more infusions according to the choice of treating physicians. Short-term outcome was colectomy/death 2 months after the first infusion. Long-term outcome was survival free from colectomy. Safety data were recorded. Results Twelve patients (15%) underwent colectomy within 2 months. One died of Legionella pneumophila infection 12 days after infliximab. Early colectomy rates were higher in patients receiving one infusion (9/26), compared with those receiving two/more infusions (3/57, P = 0.001, OR = 9.53). Seventy patients who survived colectomy and did not experience any fatal complications were followed-up for a median time of 23 months; 58 patients avoided colectomy during the follow-up. Forty-two patients were maintained on immunosuppressive drugs. No clinical features were associated with outcomes. Conclusions Infliximab is an effective and relatively safe therapy to avoid colectomy and maintain long-term remission for patients with severe refractory ulcerative colitis. In the short term, two or more infusions seem to be more effective than one single infusion.
Databáze:	OpenAIRE
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