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Infliximab as rescue therapy in hospitalised patients with steroid-refractory acute ulcerative colitis: a long-term follow-up of 211 Swedish patients

Sjoberg, M.; Magnuson, A.; Bjork, J.; Benoni, Cecilia LU ; Almer, S.; Friis-Liby, I.; Hertervig, Erik LU ; Olsson, M.; Karlen, P. and Eriksson, A., et al. (2013) In Alimentary pharmacology & therapeutics 38(4). p.377-387
Abstract
BackgroundRescue therapy with infliximab (IFX) has been proven effective in a steroid-refractory attack of ulcerative colitis (UC). The long-term efficacy is not well described. AimTo present a retrospective study of IFX as rescue therapy in UC. Primary end points were colectomy-free survival at 3 and 12months. MethodsIn this multicentre study, 211 adult patients hospitalised between 1999 and 2010 received IFX 5mg/kg as rescue therapy due to a steroid-refractory, moderate-to-severe attack of UC. Exclusion criteria were duration of current flare for >12weeks, corticosteroid treatment for >8weeks before hospitalisation, previous IFX therapy or Crohn's disease. ResultsProbability of colectomy-free survival at 3months was 0.71 (95% CI,... (More)
BackgroundRescue therapy with infliximab (IFX) has been proven effective in a steroid-refractory attack of ulcerative colitis (UC). The long-term efficacy is not well described. AimTo present a retrospective study of IFX as rescue therapy in UC. Primary end points were colectomy-free survival at 3 and 12months. MethodsIn this multicentre study, 211 adult patients hospitalised between 1999 and 2010 received IFX 5mg/kg as rescue therapy due to a steroid-refractory, moderate-to-severe attack of UC. Exclusion criteria were duration of current flare for >12weeks, corticosteroid treatment for >8weeks before hospitalisation, previous IFX therapy or Crohn's disease. ResultsProbability of colectomy-free survival at 3months was 0.71 (95% CI, 0.64-0.77), at 12months 0.64 (95% CI, 0.57-0.70), at 3years 0.59 (95% CI, 0.52-0.66) and at 5years 0.53 (95% CI, 0.44-0.61). Steroid-free, clinical remission was achieved in 105/211 (50%) and 112/209 (54%) patients at 3 and 12months respectively. Of 75 colectomies during the first year, 48 (64%) were carried out during the first 14days, 13 (17%) on days 15-90 and 14 (19%) between 3 and 12months. There were three (1.4%) deaths during the first 3months. ConclusionsInfliximab is an effective rescue treatment, both short- and long-term, in a steroid-refractory attack of UC. Most IFX failures underwent surgery during the first 14days, which calls for studies on how to optimise induction treatment with IFX. Serious complications, including mortality, were rare. (Less)
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published
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Alimentary pharmacology & therapeutics
volume
38
issue
4
pages
377 - 387
publisher
Wiley-Blackwell
external identifiers
  • wos:000321773700004
  • scopus:84880295362
ISSN
0269-2813
DOI
10.1111/apt.12387
language
English
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yes
id
a2c36da0-d65e-4090-8585-b634f2d78753 (old id 3973225)
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2013-09-02 07:38:42
date last changed
2019-07-14 03:39:34
@article{a2c36da0-d65e-4090-8585-b634f2d78753,
  abstract     = {BackgroundRescue therapy with infliximab (IFX) has been proven effective in a steroid-refractory attack of ulcerative colitis (UC). The long-term efficacy is not well described. AimTo present a retrospective study of IFX as rescue therapy in UC. Primary end points were colectomy-free survival at 3 and 12months. MethodsIn this multicentre study, 211 adult patients hospitalised between 1999 and 2010 received IFX 5mg/kg as rescue therapy due to a steroid-refractory, moderate-to-severe attack of UC. Exclusion criteria were duration of current flare for >12weeks, corticosteroid treatment for >8weeks before hospitalisation, previous IFX therapy or Crohn's disease. ResultsProbability of colectomy-free survival at 3months was 0.71 (95% CI, 0.64-0.77), at 12months 0.64 (95% CI, 0.57-0.70), at 3years 0.59 (95% CI, 0.52-0.66) and at 5years 0.53 (95% CI, 0.44-0.61). Steroid-free, clinical remission was achieved in 105/211 (50%) and 112/209 (54%) patients at 3 and 12months respectively. Of 75 colectomies during the first year, 48 (64%) were carried out during the first 14days, 13 (17%) on days 15-90 and 14 (19%) between 3 and 12months. There were three (1.4%) deaths during the first 3months. ConclusionsInfliximab is an effective rescue treatment, both short- and long-term, in a steroid-refractory attack of UC. Most IFX failures underwent surgery during the first 14days, which calls for studies on how to optimise induction treatment with IFX. Serious complications, including mortality, were rare.},
  author       = {Sjoberg, M. and Magnuson, A. and Bjork, J. and Benoni, Cecilia and Almer, S. and Friis-Liby, I. and Hertervig, Erik and Olsson, M. and Karlen, P. and Eriksson, A. and Midhagen, G. and Carlson, M. and Lapidus, A. and Halfvarson, J. and Tysk, C.},
  issn         = {0269-2813},
  language     = {eng},
  number       = {4},
  pages        = {377--387},
  publisher    = {Wiley-Blackwell},
  series       = {Alimentary pharmacology & therapeutics},
  title        = {Infliximab as rescue therapy in hospitalised patients with steroid-refractory acute ulcerative colitis: a long-term follow-up of 211 Swedish patients},
  url          = {http://dx.doi.org/10.1111/apt.12387},
  volume       = {38},
  year         = {2013},
}