Infliximab as rescue medication for patients with severe ulcerative/indeterminate colitis refractory to tacrolimus
Résumé
Background: The calcineurin inhibitor tacrolimus and the anti-TNF-antibody infliximab are established options in steroid refractory ulcerative colitis (UC). Aim: To evaluate the efficacy of infliximab-salvage therapy in patients with refractory ulcerative colitis failing to respond to tacrolimus Methods: Twenty-four patients were enrolled in this evaluation. Reasons for tacrolimus therapy were steroid-refractory disease in 19 patients and steroid dependency in 5 patients. All patients receiving infliximab had tacrolimus refractory active disease (Lichtiger score >10) and were treated with 5mg/kg at weeks 0, 2 and 6 and every 8 weeks thereafter if tolerated. Results: Six of 24 patients (25%) achieved remission following infliximab infusion and 4/24 (17%) had an initial response only but underwent proctocolectomy later due to loss of response (3) or development of a delayed hypersensitivity reaction (1). Fourteen patients (58%) completely failed to respond with 10 undergoing colectomy. Eight patients experienced side effects under infliximab including two infectious complications (herpes zoster and herpes pneumonia). Conclusions: Infliximab offers a therapeutic option as rescue therapy in about a quarter of patients with active UC after failing to respond to tacrolimus. This benefit has to be weighed against the risks of infectious complications.
Fichier principal
PEER_stage2_10.1111%2Fj.1365-2036.2010.04267.x.pdf (353.93 Ko)
Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)
Loading...