A retrospective analysis of the efficacy and safety of infliximab as rescue therapy in acute severe ulcerative colitis
Summary Background Forty per cent of patients with acute severe ulcerative colitis will not respond to intravenous corticosteroids and require second‐line medical therapy or colectomy. A recent controlled trial has suggested that infliximab may be effective as rescue therapy. Aim To assess the val...
Gespeichert in:
| Veröffentlicht in: | Alimentary Pharmacology and Therapeutics 2007-08, Vol.26 (3), p.411-419 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 419 |
|---|---|
| container_issue | 3 |
| container_start_page | 411 |
| container_title | Alimentary Pharmacology and Therapeutics |
| container_volume | 26 |
| creator | LEES, C. W. HEYS, D. HO, G. T. NOBLE, C. L. SHAND, A. G. MOWAT, C. BOULTON‐JONES, R. WILLIAMS, A. CHURCH, N. SATSANGI, J. ARNOTT, I. D. R. |
| description | Summary
Background Forty per cent of patients with acute severe ulcerative colitis will not respond to intravenous corticosteroids and require second‐line medical therapy or colectomy. A recent controlled trial has suggested that infliximab may be effective as rescue therapy.
Aim To assess the value of infliximab as rescue therapy for acute severe colitis in a retrospective cohort of ulcerative colitis patients in Scotland.
Methods All patients satisfied Truelove and Witts criteria on admission, failed to respond to intravenous corticosteroids and received infliximab (5 mg/kg) as rescue therapy. Response was defined as need for colectomy at hospital discharge and by 90 days.
Results A total of 39 patients (median age 31.7 years) were treated. 26/39 (66%) responded, avoiding colectomy during the acute admission, and were followed up for a median of 203 days (Interquartile range = 135.5–328.5). Hypoalbuminaemia was a consistent predictor of non‐response on univariate and multivariate analysis. At day 3 of intravenous steroids, 9/18 (50.0%) with serum albumin |
| doi_str_mv | 10.1111/j.1365-2036.2007.03383.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70715019</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70715019</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4783-dd4b406f1d246dc76f2f36662755d0f22b83a0ec11b01a7476d9c3b6955ff23c3</originalsourceid><addsrcrecordid>eNqNkcFu1DAQhq0K1G4Lr4B8gVvC2I7t5MBhVRWoVKk9lLPlOGPhVXaz2MmyeXuc7ooewRdb-r8Zj-YjhDIoWT6fNyUTShYchCo5gC5BiFqUxwuy-hu8ISvgqil4zcQVuU5pAwBKA78kV0wrIYVWK3JY04hjHNIe3RgOSO3O9nMKiQ6ejj-RovfBWTfnoKPJehznJQo734dj2NqW2pRbJDfhwke7n3NIrZtGpAkPGJFOvcvBS3s39GEM6R15622f8P35viE_vt49334vHh6_3d-uHwpX6VoUXVe1FSjPOl6pzmnluRdKKa6l7MBz3tbCAjrGWmBWV1p1jROtaqT0ngsnbsinU999HH5NmEazDclh39sdDlMyGjSTwJp_ghx4JaWADNYn0OWlpYje7GNeQ5wNA7PIMRuzODCLA7PIMS9yzDGXfjj_MbVb7F4LzzYy8PEM2ORs76PduZBeubrhTMEy7JcT9zv0OP_3AGb99Ly8xB9rZqtz</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>20245530</pqid></control><display><type>article</type><title>A retrospective analysis of the efficacy and safety of infliximab as rescue therapy in acute severe ulcerative colitis</title><source>Wiley Free Content</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>LEES, C. W. ; HEYS, D. ; HO, G. T. ; NOBLE, C. L. ; SHAND, A. G. ; MOWAT, C. ; BOULTON‐JONES, R. ; WILLIAMS, A. ; CHURCH, N. ; SATSANGI, J. ; ARNOTT, I. D. R.</creator><creatorcontrib>LEES, C. W. ; HEYS, D. ; HO, G. T. ; NOBLE, C. L. ; SHAND, A. G. ; MOWAT, C. ; BOULTON‐JONES, R. ; WILLIAMS, A. ; CHURCH, N. ; SATSANGI, J. ; ARNOTT, I. D. R. ; Scottish Society of Gastroenterology Infliximab Group ; ON BEHALF OF THE SCOTTISH SOCIETY OF GASTROENTEROLOGY INFLIXIMAB GROUP</creatorcontrib><description>Summary
Background Forty per cent of patients with acute severe ulcerative colitis will not respond to intravenous corticosteroids and require second‐line medical therapy or colectomy. A recent controlled trial has suggested that infliximab may be effective as rescue therapy.
Aim To assess the value of infliximab as rescue therapy for acute severe colitis in a retrospective cohort of ulcerative colitis patients in Scotland.
Methods All patients satisfied Truelove and Witts criteria on admission, failed to respond to intravenous corticosteroids and received infliximab (5 mg/kg) as rescue therapy. Response was defined as need for colectomy at hospital discharge and by 90 days.
Results A total of 39 patients (median age 31.7 years) were treated. 26/39 (66%) responded, avoiding colectomy during the acute admission, and were followed up for a median of 203 days (Interquartile range = 135.5–328.5). Hypoalbuminaemia was a consistent predictor of non‐response on univariate and multivariate analysis. At day 3 of intravenous steroids, 9/18 (50.0%) with serum albumin <34 g/L had urgent colectomy vs. 1/13 (7.7%) ≥34 g/L (P = 0.02, OR = 12.0, C.I. 1.28–112.7). Two serious adverse events occurred – one death due to Pseudomonas pneumonia, and one post‐operative fungal septicaemia.
Conclusions Infliximab represents a moderately effective rescue therapy for patients with acute severe ulcerative colitis. Serious adverse events, including death, do occur and should be discussed with patients prior to therapy.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>EISSN: 0953-0673</identifier><identifier>DOI: 10.1111/j.1365-2036.2007.03383.x</identifier><identifier>PMID: 17635376</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Acute Disease ; Adult ; Aged ; Antibodies, Monoclonal - adverse effects ; Antibodies, Monoclonal - therapeutic use ; Biological and medical sciences ; Cohort Studies ; Colitis, Ulcerative - drug therapy ; Digestive system ; Female ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastrointestinal Agents - therapeutic use ; Humans ; Infliximab ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Pharmacology. Drug treatments ; Pseudomonas ; Retrospective Studies ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Treatment Outcome</subject><ispartof>Alimentary Pharmacology and Therapeutics, 2007-08, Vol.26 (3), p.411-419</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4783-dd4b406f1d246dc76f2f36662755d0f22b83a0ec11b01a7476d9c3b6955ff23c3</citedby><cites>FETCH-LOGICAL-c4783-dd4b406f1d246dc76f2f36662755d0f22b83a0ec11b01a7476d9c3b6955ff23c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2036.2007.03383.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2036.2007.03383.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18921609$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17635376$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LEES, C. W.</creatorcontrib><creatorcontrib>HEYS, D.</creatorcontrib><creatorcontrib>HO, G. T.</creatorcontrib><creatorcontrib>NOBLE, C. L.</creatorcontrib><creatorcontrib>SHAND, A. G.</creatorcontrib><creatorcontrib>MOWAT, C.</creatorcontrib><creatorcontrib>BOULTON‐JONES, R.</creatorcontrib><creatorcontrib>WILLIAMS, A.</creatorcontrib><creatorcontrib>CHURCH, N.</creatorcontrib><creatorcontrib>SATSANGI, J.</creatorcontrib><creatorcontrib>ARNOTT, I. D. R.</creatorcontrib><creatorcontrib>Scottish Society of Gastroenterology Infliximab Group</creatorcontrib><creatorcontrib>ON BEHALF OF THE SCOTTISH SOCIETY OF GASTROENTEROLOGY INFLIXIMAB GROUP</creatorcontrib><title>A retrospective analysis of the efficacy and safety of infliximab as rescue therapy in acute severe ulcerative colitis</title><title>Alimentary Pharmacology and Therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background Forty per cent of patients with acute severe ulcerative colitis will not respond to intravenous corticosteroids and require second‐line medical therapy or colectomy. A recent controlled trial has suggested that infliximab may be effective as rescue therapy.
Aim To assess the value of infliximab as rescue therapy for acute severe colitis in a retrospective cohort of ulcerative colitis patients in Scotland.
Methods All patients satisfied Truelove and Witts criteria on admission, failed to respond to intravenous corticosteroids and received infliximab (5 mg/kg) as rescue therapy. Response was defined as need for colectomy at hospital discharge and by 90 days.
Results A total of 39 patients (median age 31.7 years) were treated. 26/39 (66%) responded, avoiding colectomy during the acute admission, and were followed up for a median of 203 days (Interquartile range = 135.5–328.5). Hypoalbuminaemia was a consistent predictor of non‐response on univariate and multivariate analysis. At day 3 of intravenous steroids, 9/18 (50.0%) with serum albumin <34 g/L had urgent colectomy vs. 1/13 (7.7%) ≥34 g/L (P = 0.02, OR = 12.0, C.I. 1.28–112.7). Two serious adverse events occurred – one death due to Pseudomonas pneumonia, and one post‐operative fungal septicaemia.
Conclusions Infliximab represents a moderately effective rescue therapy for patients with acute severe ulcerative colitis. Serious adverse events, including death, do occur and should be discussed with patients prior to therapy.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Antibodies, Monoclonal - adverse effects</subject><subject>Antibodies, Monoclonal - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Colitis, Ulcerative - drug therapy</subject><subject>Digestive system</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gastrointestinal Agents - therapeutic use</subject><subject>Humans</subject><subject>Infliximab</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Pharmacology. Drug treatments</subject><subject>Pseudomonas</subject><subject>Retrospective Studies</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Treatment Outcome</subject><issn>0269-2813</issn><issn>1365-2036</issn><issn>0953-0673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcFu1DAQhq0K1G4Lr4B8gVvC2I7t5MBhVRWoVKk9lLPlOGPhVXaz2MmyeXuc7ooewRdb-r8Zj-YjhDIoWT6fNyUTShYchCo5gC5BiFqUxwuy-hu8ISvgqil4zcQVuU5pAwBKA78kV0wrIYVWK3JY04hjHNIe3RgOSO3O9nMKiQ6ejj-RovfBWTfnoKPJehznJQo734dj2NqW2pRbJDfhwke7n3NIrZtGpAkPGJFOvcvBS3s39GEM6R15622f8P35viE_vt49334vHh6_3d-uHwpX6VoUXVe1FSjPOl6pzmnluRdKKa6l7MBz3tbCAjrGWmBWV1p1jROtaqT0ngsnbsinU999HH5NmEazDclh39sdDlMyGjSTwJp_ghx4JaWADNYn0OWlpYje7GNeQ5wNA7PIMRuzODCLA7PIMS9yzDGXfjj_MbVb7F4LzzYy8PEM2ORs76PduZBeubrhTMEy7JcT9zv0OP_3AGb99Ly8xB9rZqtz</recordid><startdate>200708</startdate><enddate>200708</enddate><creator>LEES, C. W.</creator><creator>HEYS, D.</creator><creator>HO, G. T.</creator><creator>NOBLE, C. L.</creator><creator>SHAND, A. G.</creator><creator>MOWAT, C.</creator><creator>BOULTON‐JONES, R.</creator><creator>WILLIAMS, A.</creator><creator>CHURCH, N.</creator><creator>SATSANGI, J.</creator><creator>ARNOTT, I. D. R.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>200708</creationdate><title>A retrospective analysis of the efficacy and safety of infliximab as rescue therapy in acute severe ulcerative colitis</title><author>LEES, C. W. ; HEYS, D. ; HO, G. T. ; NOBLE, C. L. ; SHAND, A. G. ; MOWAT, C. ; BOULTON‐JONES, R. ; WILLIAMS, A. ; CHURCH, N. ; SATSANGI, J. ; ARNOTT, I. D. R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4783-dd4b406f1d246dc76f2f36662755d0f22b83a0ec11b01a7476d9c3b6955ff23c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Aged</topic><topic>Antibodies, Monoclonal - adverse effects</topic><topic>Antibodies, Monoclonal - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Colitis, Ulcerative - drug therapy</topic><topic>Digestive system</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gastrointestinal Agents - therapeutic use</topic><topic>Humans</topic><topic>Infliximab</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Pharmacology. Drug treatments</topic><topic>Pseudomonas</topic><topic>Retrospective Studies</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LEES, C. W.</creatorcontrib><creatorcontrib>HEYS, D.</creatorcontrib><creatorcontrib>HO, G. T.</creatorcontrib><creatorcontrib>NOBLE, C. L.</creatorcontrib><creatorcontrib>SHAND, A. G.</creatorcontrib><creatorcontrib>MOWAT, C.</creatorcontrib><creatorcontrib>BOULTON‐JONES, R.</creatorcontrib><creatorcontrib>WILLIAMS, A.</creatorcontrib><creatorcontrib>CHURCH, N.</creatorcontrib><creatorcontrib>SATSANGI, J.</creatorcontrib><creatorcontrib>ARNOTT, I. D. R.</creatorcontrib><creatorcontrib>Scottish Society of Gastroenterology Infliximab Group</creatorcontrib><creatorcontrib>ON BEHALF OF THE SCOTTISH SOCIETY OF GASTROENTEROLOGY INFLIXIMAB GROUP</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary Pharmacology and Therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LEES, C. W.</au><au>HEYS, D.</au><au>HO, G. T.</au><au>NOBLE, C. L.</au><au>SHAND, A. G.</au><au>MOWAT, C.</au><au>BOULTON‐JONES, R.</au><au>WILLIAMS, A.</au><au>CHURCH, N.</au><au>SATSANGI, J.</au><au>ARNOTT, I. D. R.</au><aucorp>Scottish Society of Gastroenterology Infliximab Group</aucorp><aucorp>ON BEHALF OF THE SCOTTISH SOCIETY OF GASTROENTEROLOGY INFLIXIMAB GROUP</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A retrospective analysis of the efficacy and safety of infliximab as rescue therapy in acute severe ulcerative colitis</atitle><jtitle>Alimentary Pharmacology and Therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2007-08</date><risdate>2007</risdate><volume>26</volume><issue>3</issue><spage>411</spage><epage>419</epage><pages>411-419</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><eissn>0953-0673</eissn><abstract>Summary
Background Forty per cent of patients with acute severe ulcerative colitis will not respond to intravenous corticosteroids and require second‐line medical therapy or colectomy. A recent controlled trial has suggested that infliximab may be effective as rescue therapy.
Aim To assess the value of infliximab as rescue therapy for acute severe colitis in a retrospective cohort of ulcerative colitis patients in Scotland.
Methods All patients satisfied Truelove and Witts criteria on admission, failed to respond to intravenous corticosteroids and received infliximab (5 mg/kg) as rescue therapy. Response was defined as need for colectomy at hospital discharge and by 90 days.
Results A total of 39 patients (median age 31.7 years) were treated. 26/39 (66%) responded, avoiding colectomy during the acute admission, and were followed up for a median of 203 days (Interquartile range = 135.5–328.5). Hypoalbuminaemia was a consistent predictor of non‐response on univariate and multivariate analysis. At day 3 of intravenous steroids, 9/18 (50.0%) with serum albumin <34 g/L had urgent colectomy vs. 1/13 (7.7%) ≥34 g/L (P = 0.02, OR = 12.0, C.I. 1.28–112.7). Two serious adverse events occurred – one death due to Pseudomonas pneumonia, and one post‐operative fungal septicaemia.
Conclusions Infliximab represents a moderately effective rescue therapy for patients with acute severe ulcerative colitis. Serious adverse events, including death, do occur and should be discussed with patients prior to therapy.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>17635376</pmid><doi>10.1111/j.1365-2036.2007.03383.x</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2813 |
| ispartof | Alimentary Pharmacology and Therapeutics, 2007-08, Vol.26 (3), p.411-419 |
| issn | 0269-2813 1365-2036 0953-0673 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_70715019 |
| source | Wiley Free Content; MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Acute Disease Adult Aged Antibodies, Monoclonal - adverse effects Antibodies, Monoclonal - therapeutic use Biological and medical sciences Cohort Studies Colitis, Ulcerative - drug therapy Digestive system Female Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen Gastrointestinal Agents - therapeutic use Humans Infliximab Male Medical sciences Middle Aged Other diseases. Semiology Pharmacology. Drug treatments Pseudomonas Retrospective Studies Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Treatment Outcome |
| title | A retrospective analysis of the efficacy and safety of infliximab as rescue therapy in acute severe ulcerative colitis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-19T03%3A45%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20retrospective%20analysis%20of%20the%20efficacy%20and%20safety%20of%20infliximab%20as%20rescue%20therapy%20in%20acute%20severe%20ulcerative%20colitis&rft.jtitle=Alimentary%20Pharmacology%20and%20Therapeutics&rft.au=LEES,%20C.%20W.&rft.aucorp=Scottish%20Society%20of%20Gastroenterology%20Infliximab%20Group&rft.date=2007-08&rft.volume=26&rft.issue=3&rft.spage=411&rft.epage=419&rft.pages=411-419&rft.issn=0269-2813&rft.eissn=1365-2036&rft_id=info:doi/10.1111/j.1365-2036.2007.03383.x&rft_dat=%3Cproquest_cross%3E70715019%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=20245530&rft_id=info:pmid/17635376&rfr_iscdi=true |