Long-term outcomes of infliximab in a real-world multicenter cohort of patients with acute severe ulcerative colitis
| Autor: | Oh, Shin Ju, Shin, Ga Young, Soh, Hosim, Lee, Jae Gon, Im, Jong Pil, Eun, Chang Soo, Lee, Kang-Moon, Park, Dong Il, Han, Dong Soo, Kim, Hyo Jong, Lee, Chang Kyun |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Cytomegalovirus colitis RC799-869 Internal medicine medicine Colectomy colitis ulcerative business.industry Hazard ratio Gastroenterology Retrospective cohort study Diseases of the digestive system. Gastroenterology Inflammatory Bowel Diseases colectomy medicine.disease Ulcerative colitis Infliximab Cohort Medicine Original Article infliximab business hospitalization Cohort study medicine.drug |
| Zdroj: | Intestinal Research, Vol 19, Iss 3, Pp 323-331 (2021) Intestinal Research |
| ISSN: | 2288-1956 1598-9100 |
| DOI: | 10.5217/ir.2020.00039 |
| Popis: | Background/Aims: Infliximab (IFX) has proven effective as rescue therapy in steroid-refractory acute severe ulcerative colitis (ASUC), however, the long-term real-world data are scarce. Our study aimed to assess the long-term treatment outcomes of IFX in a real-life cohort.Methods: We established a multicenter retrospective cohort of hospitalized patients with ASUC, who met Truelove and Witt’s criteria and received intravenous corticosteroid (IVCS) or IFX during index hospitalization between 2006 and 2016 in 5 university hospitals in Korea. The cohort was systematically followed up until colectomy, death or last follow-up visit.Results: A total of 296 patients were followed up for a mean of 68.9 ± 44.0 months. During index hospitalization, 49 patients were treated with IFX; as rescue therapy for IVCS failure in 37 and as first-line medical therapy for ASUC in 12. All patients treated with IFX avoided colectomy during index hospitalization. The cumulative rates of rehospitalization and colectomy were 20.4% and 6.1% at 3 months and 39.6% and 18.8% at the end of follow-up, respectively. Patients treated with IFX presented with significantly shorter colectomy-free survival than IVCS responders (P= 0.04, log-rank test). Both cytomegalovirus colitis and Clostridioides difficile infection (CDI) were the significant predictors of colectomy in the overall study cohort (hazard ratios of 6.57 and 4.61, respectively). There were no fatalities.Conclusions: Our real-world cohort study demonstrated that IFX is an effective therapeutic option in Korean patients with ASUC, irrespective of IFX indication. Aggressive vigilance for cytomegalovirus colitis and CDI is warranted for hospitalized patients with ASUC. |
| Databáze: | OpenAIRE |
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