Infliximab for acute, not steroid-refractory ulcerative colitis: a randomized pilot study

Area of Science:

• Gastroenterology
• Immunology
• Clinical Medicine

Background:

• Acute ulcerative colitis often lacks effective treatments when steroids are contraindicated.
• Infliximab, an antibody targeting tumor necrosis factor alpha, has shown efficacy in steroid-refractory ulcerative colitis.
• This study investigates infliximab's effectiveness in acute ulcerative pancolitis patients not refractory to steroids.

Purpose of the Study:

• To evaluate the efficacy of infliximab in achieving remission in patients with acute ulcerative pancolitis.
• To compare infliximab treatment with high-dose prednisolone in this patient population.

Main Methods:

• Patients with acute ulcerative pancolitis (activity score >10) not on immunomodulators or high-dose prednisolone were enrolled.
• Participants were randomized to receive either infliximab infusions (5 mg/kg) or high-dose prednisolone.
• Therapy success was defined by a significant decrease in clinical activity scores at 3 and 13 weeks.

Main Results:

• Thirteen patients were randomized: six received infliximab and seven received prednisolone.
• Both groups showed high rates of therapy success: 5/6 in the infliximab group and 6/7 in the prednisolone group at 3 and 13 weeks.
• Median baseline activity scores were comparable between groups.

Conclusions:

• Infliximab demonstrates potential effectiveness for treating acute moderate to severe ulcerative colitis.
• The findings suggest infliximab as a viable therapeutic alternative.
• Larger controlled trials are warranted to confirm these results.