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Infliximab for treatment of steroid-refractory ulcerative colitis
G C Actis1, M Bruno, M Pinna-Pintor
1Department of Digestive Diseases, Molinette Hospital, Turin, Italy. Actis_g@libero.it
Summary
Infliximab shows limited sustained response in severe ulcerative colitis. This study found only 25% of patients achieved long-term remission, suggesting a need to re-evaluate its use as a rescue therapy.
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Monoclonal anti-tumour necrosis factor antibody infliximab is being explored for ulcerative colitis treatment.
- Previous studies in Crohn's disease prompted its investigation in ulcerative colitis.
- Initial results in steroid-refractory ulcerative colitis patients show a 50% initial response and 25% remission rate.
Purpose of the Study:
- To analyze data from an open trial of infliximab in severe, steroid-refractory ulcerative colitis patients.
- To evaluate the efficacy of infliximab as a rescue treatment in this patient population.
Main Methods:
- An open trial was conducted on 8 consecutive patients with uncontrolled ulcerative colitis.
- Six of the 8 patients were non-responders to parenteral steroids.
- All patients received an initial intravenous infusion of infliximab at 5 mg/kg.
Main Results:
- Four out of 8 patients (50%) did not respond to the first infliximab dose and required urgent colectomy.
- Four patients responded clinically; two achieved sustained remission for 7 months without steroids.
- One patient relapsed and underwent colectomy, while another showed partial response to repeat infusion.
Conclusions:
- The sustained response rate in this study was 25% (2/8 patients).
- Findings align with other independent studies on infliximab for ulcerative colitis.
- These results suggest a need to reappraise the use of infliximab as rescue therapy for refractory ulcerative colitis.