Literature DB >> 33104766

Comparison of medium to long-term outcomes of acute severe ulcerative colitis patients receiving accelerated and standard infliximab induction.

David J Gibson1, Jayne Doherty1, Mairead McNally2, John Campion3, Denise Keegan1, Aine Keogh2, Una Kennedy3, Kathryn Byrne1, Laurence J Egan2,4, Susan McKiernan3, FInbar MacCarthy3, Subhasish Sengupta5, Juliette Sheridan1, Hugh E Mulcahy1, Garret Cullen1, Eoin Slattery2, David Kevans3, Glen A Doherty1.   

Abstract

INTRODUCTION: Accelerated dose infliximab (IFX) induction is associated with reduced short-term colectomy rate in acute severe ulcerative colitis (ASUC). Data on medium/long-term outcomes of this strategy are limited. AIMS: Evaluate medium/long-term outcomes in patients receiving IFX induction for ASUC, comparing accelerated dose (AD) and standard dose (SD) induction.
METHODS: Retrospective study of consecutive patients admitted with corticosteroid-refractory ASUC in four tertiary referral centres within INITIative IBD research network (www.initiativeibd.ie). IFX rescue was given either as SD (weeks 0, 2, 6) or AD (<28 days) from January 2010 to September 2017. AD induction has been utilised in participating centres since 2014. Consequently SD patients were subdivided based on time period of IFX rescue: historical SD group (SD1) (2010-2013) and current SD group (SD2) (2014-2017). Primary endpoint was time to colectomy; secondary endpoint was time to IFX discontinuation if induction was complete.
RESULTS: 145 patients received rescue IFX (AD=58, SD1=32, SD2=55). Disease severity at induction was comparable between AD and SD1 groups; however, SD2 group had less severe disease: median C-reactive protein (CRP) 39, 44 and 20 mg/L for AD, SD1 and SD2 groups, respectively (p=0.026, Kruskal-Wallis); median CRP: albumin ratio was 1.4, 1.8 and 0.6 (p=0.016). Median follow-up for AD, SD1 and SD2 groups was 1.6 (IQR 1.1-3.1), 4.9 (IQR 2.6-5.5) and 1.5 (IQR 0.9-2.3) years. Time to colectomy was shorter in SD1 (log rank p=0.0013); no significant difference in time to colectomy was observed comparing AD and SD2 groups (log rank p=0.32). 123 patients (84%) completed IFX induction and received maintenance therapy. Time to IFX discontinuation was shorter in SD1 (log rank p=0.009).
CONCLUSION: Time to colectomy is significantly prolonged with use of AD IFX in selected ASUC patients with more severe disease. Historical use of standard IFX induction for all ASUC patients is associated with inferior long-term outcomes. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Entities:  

Keywords:  IBD clinical; inflammatory bowel disease; infliximab

Year:  2019        PMID： 33104766      PMCID： PMC7569515          DOI： 10.1136/flgastro-2019-101335

Source DB:  PubMed          Journal:  Frontline Gastroenterol        ISSN： 2041-4137


  14 in total

1.  CRP/Albumin Ratio: An Early Predictor of Steroid Responsiveness in Acute Severe Ulcerative Colitis.

Authors:  David J Gibson; Karen Hartery; Jayne Doherty; Jack Nolan; Denise Keegan; Kathryn Byrne; Sean T Martin; Maire Buckley; Juliette Sheridan; Gareth Horgan; Hugh E Mulcahy; Garret Cullen; Glen A Doherty
Journal:  J Clin Gastroenterol       Date:  2018-07       Impact factor: 3.062

2.  An accelerated infliximab induction regimen reduces the need for early colectomy in patients with acute severe ulcerative colitis.

Authors:  David J Gibson; Zaid S Heetun; Ciaran E Redmond; Kavin S Nanda; Denise Keegan; Kathryn Byrne; Hugh E Mulcahy; Garret Cullen; Glen A Doherty
Journal:  Clin Gastroenterol Hepatol       Date:  2014-07-30       Impact factor: 11.382

Review 3.  British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults.

Authors:  Christopher Andrew Lamb; Nicholas A Kennedy; Tim Raine; Philip Anthony Hendy; Philip J Smith; Jimmy K Limdi; Bu'Hussain Hayee; Miranda C E Lomer; Gareth C Parkes; Christian Selinger; Kevin J Barrett; R Justin Davies; Cathy Bennett; Stuart Gittens; Malcolm G Dunlop; Omar Faiz; Aileen Fraser; Vikki Garrick; Paul D Johnston; Miles Parkes; Jeremy Sanderson; Helen Terry; Daniel R Gaya; Tariq H Iqbal; Stuart A Taylor; Melissa Smith; Matthew Brookes; Richard Hansen; A Barney Hawthorne
Journal:  Gut       Date:  2019-09-27       Impact factor: 23.059

4.  Infliximab as rescue therapy in hospitalised patients with steroid-refractory acute ulcerative colitis: a long-term follow-up of 211 Swedish patients.

Authors:  M Sjöberg; A Magnuson; J Björk; C Benoni; S Almer; I Friis-Liby; E Hertervig; M Olsson; P Karlén; A Eriksson; G Midhagen; M Carlson; A Lapidus; J Halfvarson; C Tysk
Journal:  Aliment Pharmacol Ther       Date:  2013-06-25       Impact factor: 8.171

5.  Predicting outcome in severe ulcerative colitis.

Authors:  S P Travis; J M Farrant; C Ricketts; D J Nolan; N M Mortensen; M G Kettlewell; D P Jewell
Journal:  Gut       Date:  1996-06       Impact factor: 23.059

6.  Long-term outcome of patients with steroid-refractory acute severe UC treated with ciclosporin or infliximab.

Authors:  D Laharie; A Bourreille; J Branche; M Allez; Y Bouhnik; J Filippi; F Zerbib; G Savoye; L Vuitton; J Moreau; A Amiot; J Cosnes; E Ricart; O Dewit; A Lopez-Sanroman; M Fumery; F Carbonnel; G Bommelaer; B Coffin; X Roblin; G van Assche; M Esteve; M Farkkila; J P Gisbert; P Marteau; S Nahon; M de Vos; J Lambert; J Y Mary; E Louis
Journal:  Gut       Date:  2017-01-04       Impact factor: 23.059

7.  Infliximab as rescue therapy in severe to moderately severe ulcerative colitis: a randomized, placebo-controlled study.

Authors:  Gunnar Järnerot; Erik Hertervig; Ingalill Friis-Liby; Lars Blomquist; Per Karlén; Christer Grännö; Mogens Vilien; Magnus Ström; Ake Danielsson; Hans Verbaan; Per M Hellström; Anders Magnuson; Bengt Curman
Journal:  Gastroenterology       Date:  2005-06       Impact factor: 22.682

8.  Loss of Infliximab Into Feces Is Associated With Lack of Response to Therapy in Patients With Severe Ulcerative Colitis.

Authors:  Johannan F Brandse; Gijs R van den Brink; Manon E Wildenberg; Desiree van der Kleij; Theo Rispens; Jeroen M Jansen; Ron A Mathôt; Cyriel Y Ponsioen; Mark Löwenberg; Geert R A M D'Haens
Journal:  Gastroenterology       Date:  2015-04-25       Impact factor: 22.682

9.  Pushing the pedal to the metal: should we accelerate infliximab therapy for patients with severe ulcerative colitis?

Authors:  Hans H Herfarth; Gerhard Rogler; Peter D R Higgins
Journal:  Clin Gastroenterol Hepatol       Date:  2014-10-05       Impact factor: 11.382

10.  Exploration of Predictive Biomarkers of Early Infliximab Response in Acute Severe Colitis: A Prospective Pilot Study.

Authors:  Lauren Beswick; Ourania Rosella; Gennaro Rosella; Belinda Headon; Miles P Sparrow; Peter R Gibson; Daniel R van Langenberg
Journal:  J Crohns Colitis       Date:  2018-02-28       Impact factor: 9.071
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  2 in total

1.  Accelerated Infliximab Induction for Severe Lower Gastrointestinal Bleeding in a Young Patient with Crohn's Disease: A Case Report.

Authors:  Jing Zeng; Feng Shen; Jian-Gao Fan; Wen-Song Ge
Journal:  World J Clin Cases       Date:  2022-01-14       Impact factor: 1.337

Review 2.  Management of Non-response and Loss of Response to Anti-tumor Necrosis Factor Therapy in Inflammatory Bowel Disease.

Authors:  Jan Marsal; Manuel Barreiro-de Acosta; Irina Blumenstein; Maria Cappello; Thomas Bazin; Shaji Sebastian
Journal:  Front Med (Lausanne)       Date:  2022-06-15
  2 in total

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