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Article Dans Une Revue Alimentary Pharmacology and Therapeutics Année : 2010

Infliximab as rescue medication for patients with severe ulcerative/indeterminate colitis refractory to tacrolimus

Klaus R. Herrlinger
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Daniel N Barthel
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Klaus Jürgen Schmidt
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Juergen Buening
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Christiane S Barthel
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Jan Wehkamp
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Klaus Fellermann
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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.

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Dates et versions

hal-00552529 , version 1 (06-01-2011)

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Klaus R. Herrlinger, Daniel N Barthel, Klaus Jürgen Schmidt, Juergen Buening, Christiane S Barthel, et al.. Infliximab as rescue medication for patients with severe ulcerative/indeterminate colitis refractory to tacrolimus. Alimentary Pharmacology and Therapeutics, 2010, ⟨10.1111/j.1365-2036.2010.04267.x⟩. ⟨hal-00552529⟩

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