Cyclosporine or infliximab as rescue therapy in severe2 refractory ulcerative colitis: Early and long-term data3 from a retrospective observational study

Mario Cottone, Filippo Mocciaro

Risultato della ricerca: Article

42 Citazioni (Scopus)

Abstract

Introduction: About 30–40% of patients with acute severe ulcerative colitis (UC) fail to respond23 to intensive intravenous (iv) corticosteroid treatment. Iv cyclosporine and infliximab are an ef-24 fective rescue therapy in steroid-refractory UC patients but up to now it is still unclear which isQ225 the best therapeutic choice in this setting of patients.26 Methods: We reviewed our series of severe steroid-refractory colitis admitted consecutively in27 our referral center since 1994 comparing two historical cohort treated with cyclosporine or28 infliximab. Iv cyclosporine was administered at the dosage of 2 mg/kg and infliximab at the dos-29 age of 5 mg/kg. The main outcome was the colectomy rate at 3 months, 12 months and at the30 end of the follow-up.31 Results: A total of 65 patients were included: 35 in the cyclosporine group and 30 in the inflix-32 imab one. After 3 months from the acute episode the colectomy rate was: 28.5% (10/35) in the33 cyclosporine group and 17% (5/30) in the infliximab group (p=0.25). At 12 months the rate of34 colectomy increased to 48% in the cyclosporine group versus 17% in the infliximab group35 (p=0.007, OR 4.7; 95% CI: 1.47–15.16). The 1–2–3 year cumulative colectomy rates were 48%,36 54%, and 57% in the cyclosporine group, and 17%, 23%, and 27% in the infliximab group. At the37 end of the follow-up the colectomy rate was: 60% in the cyclosporine group and 30% in the inflix-38 imab group (p=0.04, HR 2.2; 95% CI: 1.11–4.86). High level of C reactive protein (p=0.04, OR39 2.9; 95% CI: 1.18–8.28), extensive disease (p=0.01, OR 5.5; 95% CI: 1.57–19.01) and no azathi-40 oprine treatment after the rescue therapy (pb0.001, OR 8.7; 95% CI: 2.49–30.12) were related41 to the risk of colectomy.
Lingua originaleEnglish
pagine (da-a)681-686
Numero di pagine6
RivistaJournal of Crohn's and Colitis
Volume6
Stato di pubblicazionePublished - 2012

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Ulcerative Colitis
Cyclosporine
Observational Studies
Colectomy
Retrospective Studies
Therapeutics
Steroids
Infliximab
Colitis
C-Reactive Protein
Adrenal Cortex Hormones
Referral and Consultation

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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@article{132f30c5f2714aaa811599ced4f92656,
title = "Cyclosporine or infliximab as rescue therapy in severe2 refractory ulcerative colitis: Early and long-term data3 from a retrospective observational study",
abstract = "Introduction: About 30–40{\%} of patients with acute severe ulcerative colitis (UC) fail to respond23 to intensive intravenous (iv) corticosteroid treatment. Iv cyclosporine and infliximab are an ef-24 fective rescue therapy in steroid-refractory UC patients but up to now it is still unclear which isQ225 the best therapeutic choice in this setting of patients.26 Methods: We reviewed our series of severe steroid-refractory colitis admitted consecutively in27 our referral center since 1994 comparing two historical cohort treated with cyclosporine or28 infliximab. Iv cyclosporine was administered at the dosage of 2 mg/kg and infliximab at the dos-29 age of 5 mg/kg. The main outcome was the colectomy rate at 3 months, 12 months and at the30 end of the follow-up.31 Results: A total of 65 patients were included: 35 in the cyclosporine group and 30 in the inflix-32 imab one. After 3 months from the acute episode the colectomy rate was: 28.5{\%} (10/35) in the33 cyclosporine group and 17{\%} (5/30) in the infliximab group (p=0.25). At 12 months the rate of34 colectomy increased to 48{\%} in the cyclosporine group versus 17{\%} in the infliximab group35 (p=0.007, OR 4.7; 95{\%} CI: 1.47–15.16). The 1–2–3 year cumulative colectomy rates were 48{\%},36 54{\%}, and 57{\%} in the cyclosporine group, and 17{\%}, 23{\%}, and 27{\%} in the infliximab group. At the37 end of the follow-up the colectomy rate was: 60{\%} in the cyclosporine group and 30{\%} in the inflix-38 imab group (p=0.04, HR 2.2; 95{\%} CI: 1.11–4.86). High level of C reactive protein (p=0.04, OR39 2.9; 95{\%} CI: 1.18–8.28), extensive disease (p=0.01, OR 5.5; 95{\%} CI: 1.57–19.01) and no azathi-40 oprine treatment after the rescue therapy (pb0.001, OR 8.7; 95{\%} CI: 2.49–30.12) were related41 to the risk of colectomy.",
keywords = "cyclosporine;infliximab, ulcerative colitis",
author = "Mario Cottone and Filippo Mocciaro",
year = "2012",
language = "English",
volume = "6",
pages = "681--686",
journal = "Journal of Crohn's and Colitis",
issn = "1873-9946",
publisher = "Elsevier",

}

TY - JOUR

T1 - Cyclosporine or infliximab as rescue therapy in severe2 refractory ulcerative colitis: Early and long-term data3 from a retrospective observational study

AU - Cottone, Mario

AU - Mocciaro, Filippo

PY - 2012

Y1 - 2012

N2 - Introduction: About 30–40% of patients with acute severe ulcerative colitis (UC) fail to respond23 to intensive intravenous (iv) corticosteroid treatment. Iv cyclosporine and infliximab are an ef-24 fective rescue therapy in steroid-refractory UC patients but up to now it is still unclear which isQ225 the best therapeutic choice in this setting of patients.26 Methods: We reviewed our series of severe steroid-refractory colitis admitted consecutively in27 our referral center since 1994 comparing two historical cohort treated with cyclosporine or28 infliximab. Iv cyclosporine was administered at the dosage of 2 mg/kg and infliximab at the dos-29 age of 5 mg/kg. The main outcome was the colectomy rate at 3 months, 12 months and at the30 end of the follow-up.31 Results: A total of 65 patients were included: 35 in the cyclosporine group and 30 in the inflix-32 imab one. After 3 months from the acute episode the colectomy rate was: 28.5% (10/35) in the33 cyclosporine group and 17% (5/30) in the infliximab group (p=0.25). At 12 months the rate of34 colectomy increased to 48% in the cyclosporine group versus 17% in the infliximab group35 (p=0.007, OR 4.7; 95% CI: 1.47–15.16). The 1–2–3 year cumulative colectomy rates were 48%,36 54%, and 57% in the cyclosporine group, and 17%, 23%, and 27% in the infliximab group. At the37 end of the follow-up the colectomy rate was: 60% in the cyclosporine group and 30% in the inflix-38 imab group (p=0.04, HR 2.2; 95% CI: 1.11–4.86). High level of C reactive protein (p=0.04, OR39 2.9; 95% CI: 1.18–8.28), extensive disease (p=0.01, OR 5.5; 95% CI: 1.57–19.01) and no azathi-40 oprine treatment after the rescue therapy (pb0.001, OR 8.7; 95% CI: 2.49–30.12) were related41 to the risk of colectomy.

AB - Introduction: About 30–40% of patients with acute severe ulcerative colitis (UC) fail to respond23 to intensive intravenous (iv) corticosteroid treatment. Iv cyclosporine and infliximab are an ef-24 fective rescue therapy in steroid-refractory UC patients but up to now it is still unclear which isQ225 the best therapeutic choice in this setting of patients.26 Methods: We reviewed our series of severe steroid-refractory colitis admitted consecutively in27 our referral center since 1994 comparing two historical cohort treated with cyclosporine or28 infliximab. Iv cyclosporine was administered at the dosage of 2 mg/kg and infliximab at the dos-29 age of 5 mg/kg. The main outcome was the colectomy rate at 3 months, 12 months and at the30 end of the follow-up.31 Results: A total of 65 patients were included: 35 in the cyclosporine group and 30 in the inflix-32 imab one. After 3 months from the acute episode the colectomy rate was: 28.5% (10/35) in the33 cyclosporine group and 17% (5/30) in the infliximab group (p=0.25). At 12 months the rate of34 colectomy increased to 48% in the cyclosporine group versus 17% in the infliximab group35 (p=0.007, OR 4.7; 95% CI: 1.47–15.16). The 1–2–3 year cumulative colectomy rates were 48%,36 54%, and 57% in the cyclosporine group, and 17%, 23%, and 27% in the infliximab group. At the37 end of the follow-up the colectomy rate was: 60% in the cyclosporine group and 30% in the inflix-38 imab group (p=0.04, HR 2.2; 95% CI: 1.11–4.86). High level of C reactive protein (p=0.04, OR39 2.9; 95% CI: 1.18–8.28), extensive disease (p=0.01, OR 5.5; 95% CI: 1.57–19.01) and no azathi-40 oprine treatment after the rescue therapy (pb0.001, OR 8.7; 95% CI: 2.49–30.12) were related41 to the risk of colectomy.

KW - cyclosporine;infliximab

KW - ulcerative colitis

UR - http://hdl.handle.net/10447/63634

M3 - Article

VL - 6

SP - 681

EP - 686

JO - Journal of Crohn's and Colitis

JF - Journal of Crohn's and Colitis

SN - 1873-9946

ER -