Comparison of outcomes of cyclosporine A and infliximab for steroid-refractory acute severe ulcerative colitis
- Alternative Title
- Comparison of outcomes of cyclosporine A and infliximab for steroid-refractory acute severe ulcerative colitis
- Abstract
- Background and aim: Data comparing the outcomes of cyclosporin A (CsA) and infliximab (IFX) as rescue therapy for steroid-refractory acute severe ulcerative colitis (SR-ASUC) among Asians are scarce.
Methods: In this single-center study, we retrospectively reviewed 121 patients with SR-ASUC according to the Truelove and Witts' criteria who received CsA or IFX as rescue therapy between 1995 and 2015. The cumulative rates of treatment failure and colectomy at 3 months were compared. Treatment failure was defined as colectomy, switch to other medications, acute flare-up events requiring steroid treatment, or adverse events leading to drug interruption.
Results: Among 121 patients with SR-ASUC (male, 55.6%; median disease duration, 47.1 months; extensive colitis, 61.2%), 23 received CsA as rescue therapy. Baseline characteristics (e.g. age at diagnosis, sex, disease duration, disease extent at rescue therapy, and Mayo score at treatment initiation) were comparable between the two groups. During follow-up (median, 45 months; interquartile range 29.3-61.8), 84 patients (69.4%) experienced treatment failure, and 25 patients (20.7%) underwent colectomy. The CsA group and the IFX group did not show significant differences in the cumulative rates of treatment failure (39.1% vs 34.7%, P = 0.714) and colectomy (26.1% vs 13.3%, P = 0.198) at 3 months. Previous use of azathioprine (odds ratio [OR] = 2.309, 95% confidence interval [CI] = 1.076-4.951, P = 0.032) was associated with treatment failure at 3 months. Mayo score > 10 at the time of rescue therapy was significantly associated with colectomy at 3 months (OR = 8.444, 95% CI = 2.592-27.506, P < 0.001).
Conclusion: Among Korean patients with SR-ASUC, the rates of treatment failure and colectomy at 3 months were not significantly different between the CSA and the IFX treatment groups.
- Author(s)
- 송은미; 오은혜; 황성욱; 박상형; 양동훈; 변정식; 명승재; 양석균; 예병덕
- Issued Date
- 2021
- Type
- Article
- Keyword
- colectomy; Comparative analysis; Cyclosporiine; Infliximab; Medical research; Medicine; Experimental; Ulcerative colitis
- DOI
- 10.1111/jgh.15508
- URI
- https://oak.ulsan.ac.kr/handle/2021.oak/7195
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2507150555&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Comparison%20of%20outcomes%20of%20cyclosporine%20A%20and%20infliximab%20for%20steroid-refractory%20acute%20severe%20ulcerative%20colitis&offset=0&pcAvailability=true
- Publisher
- JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
- Location
- 오스트레일리아
- Language
- 영어
- ISSN
- 0815-9319
- Citation Volume
- 36
- Citation Number
- 9
- Citation Start Page
- 2463
- Citation End Page
- 2470
-
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