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Comparison of outcomes of cyclosporine A and infliximab for steroid-refractory acute severe ulcerative colitis

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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)
송은미오은혜황성욱박상형양동훈변정식명승재양석균예병덕
Issued Date
2021
Type
Article
Keyword
colectomyComparative analysisCyclosporiineInfliximabMedical researchMedicineExperimentalUlcerative 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&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Comparison%20of%20outcomes%20of%20cyclosporine%20A%20and%20infliximab%20for%20steroid-refractory%20acute%20severe%20ulcerative%20colitis&amp;offset=0&amp;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
Appears in Collections:
Medicine > Medicine
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