Infliximab and ulcerative colitis

Mario Cottone, Irene Modesto

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Expert Opin Biol Ther. 2006 Apr;6(4):401-8.Infliximab and ulcerative colitis.Cottone M, Mocciaro F, Modesto I.Università di Palermo, Istituto di Medicina Generale e Pneumologia, Via Trabucco 180, Palermo, Italy. dickens@tin.itTumour necrosis factor (TNF)-alpha is an inflammatory cytokine that plays a main role in the inflammatory process underlying inflammatory bowel disease (IBD).Despite the fact that the cytokine profiles associated with ulcerative colitis(UC) and Crohn's disease (CD) are classically considered different (a Th2 patternin UC and a Th1 pattern in CD), there are several evidences in vitro and in vivo that TNF-alpha has an important role in UC. For this reason, infliximab, thechimeric monoclonal antibody to TNF-alpha, has been evaluated in the therapy ofUC. The drug has been evaluated in different clinical settings both in adults andin children: in moderate-severe steroid-dependent UC, in severe refractory UC as rescue therapy, in active non-steroid-refractory UC, in resistant pouchitis andin maintenance of moderate-severe UC responsive to infliximab. On the basis ofthe randomised controlled trials (RCTs), it is possible to draw the followingconclusions for adults: infliximab seems active in severe steroid-refractory UC, allowing colectomy to be spared even if further controlled trials are needed witha larger sample of patients adopting strict and well-defined inclusion criteria. The drug seems active in inducing remission after 8 weeks in steroid-refractorypatients, in patients taking steroids (even if it is not clear at which dosage ofsteroid dependence the drug is more active) and also in patients failingaminosalicylates therapy. The long-term response of infliximab in comparison toplacebo in these subgroups of patients is not clinically impressive even if it isstatistically significant. Further trials are warranted in order to establish therole of infliximab in steroid-dependent UC (defined with clear criteria), inmaintaining remission after severe UC, in non-steroid-dependent moderate-severeUC and in refractory pouchitis. For children it is not possible to draw the same conclusions, due to a lack of RCTs, despite the encouraging data coming from openstudies, mainly in steroid-refractory UC.PMID: 16548766 [PubMed - indexed for MEDLINE]
Original languageEnglish
Pages (from-to)401-408
Number of pages8
JournalExpert Opinion on Biological Therapy
Volume6
Publication statusPublished - 2006

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Drug Discovery
  • Clinical Biochemistry

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