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Title: Tacrolimus or infliximab for severe ulcerative colitis: short-term and long-term data from a retrospective observational study
Authors: Minami, Naoki
Yoshino, Takuya
Matsuura, Minoru  kyouindb  KAKEN_id
Koshikawa, Yorimitsu
Yamada, Satoshi
Toyonaga, Takahiko
Madian, Ali
Honzawa, Yusuke  kyouindb  KAKEN_id
Nakase, Hiroshi
Author's alias: 吉野, 琢哉
松浦, 稔
越川, 頼光
本澤, 有介
仲瀬, 裕志
Keywords: INFLAMMATORY BOWEL DISEASE
IBD CLINICAL
ULCERATIVE COLITIS
Issue Date: 20-Feb-2015
Publisher: BMJ Publishing Group
Journal title: BMJ Open Gastroenterology
Volume: 2
Issue: 1
Thesis number: e000021
Abstract: [Objective]Treatment of severe ulcerative colitis (UC) is challenging. Although the efficacy of tacrolimus (TAC) and infliximab (IFX) have been evaluated in patients with severe UC, the safety and efficacy levels of sequential therapies (TAC→IFX/IFX→TAC) in these patients remain unclear. The aim of this study was to assess short-term and long-term outcomes in patients with severe UC treated with TAC and IFX. [Methods]From October 2001 to February 2014, 29 patients with consecutive severe UC treated with TAC or IFX were retrospectively evaluated. Median follow-up duration was 27 months (range 0.5–118 months). The primary end point was short-term outcomes at 8 weeks after induction of TAC (TAC group, n=22) or IFX (IFX group, n=7). The secondary end point included long-term outcomes and colectomy-free survival. The clinical response was evaluated based on a partial Mayo score. [Results]The clinical remission (CR) rate at 8 weeks in the TAC and IFX groups was 63.6% and 71.4%, respectively. In 13 of the 29 patients (10 in the TAC group, 3 in the IFX group), sequential therapies were used in their clinical courses. In 9 of these 13 patients (6 in the TAC group, 3 in the IFX group), CR was achieved and maintained by sequential therapies. Overall cumulative colectomy-free survival was 79.3% at 118 months. [Conclusions]TAC and IFX had similar effects on remission induction in patients with severely active UC. Sequential therapies could rescue patients with UC who failed initial treatment with TAC or IFX. In clinical practice, sequential therapies might be deliberately performed.
Rights: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
URI: http://hdl.handle.net/2433/216417
DOI(Published Version): 10.1136/bmjgast-2014-000021
PubMed ID: 26462273
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