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Infliximab or cyclosporine as rescue therapy in hospitalized patients with steroid-refractory ulcerative colitis : a retrospective observational study

Sjöberg, Mats, 1965- (författare)
Department of Medicine, Skaraborgs hospital, Lidköping, Sweden
Walch, Andrea (författare)
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University Vienna, Vienna, Austria
Hellström, Per M., 1954- (författare)
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University Vienna, Vienna, Austria,Karolinska University Hospital, Solna
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Gustavsson, Anders, 1964- (författare)
Örebro universitet,Institutionen för hälsovetenskap och medicin,Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden
Järnerot, Gunnar (författare)
Örebro universitet,Institutionen för hälsovetenskap och medicin,Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden
Vogelsang, Harald (författare)
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University Vienna, Vienna, Austria
Hertervig, Erik (författare)
Lund University,Lunds universitet,Medicin, Lund,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medicine, Lund,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital, Lund University
Novacek, Gottfried (författare)
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University Vienna, Vienna, Austria
Friis-Liby, Ingalill (författare)
Department of Medicine, Division of Gastroenterology, Sahlgrenska University Hospital, Gothenburg, Sweden
Blomquist, Lars (författare)
Department of Gastroenterology and Hepatology, Karolinska University Hospital Solna, Stockholm, Sweden
Angelberger, Sieglinde (författare)
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University Vienna, Vienna, Austria
Karlén, Per (författare)
Karolinska Institutet,Södersjukhuset, Stockholm
Granno, Christer (författare)
Department of Medicine, Division of Gastroenterology, Ryhov Hospital, Jönköping, Sweden
Vilien, Mogens (författare)
Division of Gastroenterology, Hilleroed Hospital, Hilleroed, Denmark
Ström, Magnus (författare)
Östergötlands Läns Landsting,Linköpings universitet,Gastroenterologi och hepatologi,Hälsouniversitetet,Endokrin- och magtarmmedicinska kliniken US
Verbaan, Hans (författare)
Lund University,Lunds universitet,Gastroenterologi,Forskargrupper vid Lunds universitet,Gastroenterology,Lund University Research Groups,Skåne University Hospital, Malmö
Hellström, Per M. (författare)
Department of Gastroenterology and Hepatology, Karolinska University Hospital Solna, Stockholm, Sweden
Dejaco, Clemens (författare)
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University Vienna, Vienna, Austria
Magnuson, Anders (författare)
Clinical epidemiology and biostatistic unit, Örebro University Hospital, Örebro, Sweden
Halfvarson, Jonas, 1970- (författare)
Örebro universitet,Institutionen för hälsovetenskap och medicin,Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden
Reinisch, Walter (författare)
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University Vienna, Vienna, Austria
Tysk, Curt, 1949- (författare)
Örebro universitet,Institutionen för hälsovetenskap och medicin,Örebro University Hospital
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 (creator_code:org_t)
John Wiley & Sons, 2012
2012
Engelska.
Ingår i: Inflammatory Bowel Diseases. - : John Wiley & Sons. - 1078-0998 .- 1536-4844. ; 18:2, s. 212-218
Relaterad länk:
http://dx.doi.org/10...
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https://urn.kb.se/re...
https://doi.org/10.1...
https://urn.kb.se/re...
https://lup.lub.lu.s...
http://kipublication...
https://urn.kb.se/re...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Background: Cyclosporine (CsA) or infliximab (IFX) are used as rescue therapies in steroid-refractory, severe attacks of ulcerative colitis (UC). There are no data comparing the efficacy of these two alternatives. Methods: Outcome of rescue therapy was retrospectively studied in two cohorts of patients hospitalized due to steroid-refractory moderate to severe UC: 1) a Swedish-Danish cohort (n 49) treated with a single infusion of IFX; 2) an Austrian cohort (n 43) treated with intravenous CsA. After successful rescue therapy, maintenance immunomodulator treatment was given to 27/33 (82%) of IFX patients and to 31/40 (78%) of CsA patients. Endpoints were colectomy-free survival at 3 and 12 months. Kaplan-Meier and Cox regression models were used to evaluate the association between treatment groups and colectomy. Results: At 15 days, colectomy-free survival in the IFX cohort was 36/49 (73%) versus 41/43 (95%) in the CsA cohort (P = 0.005), at 3 months 33/49 (67%) versus 40/43 (93%) (P = 0.002), and at 12 months 28/49 (57%) versus 33/43 (77%) (P = 0.034). After adjusting for potential confounding factors, Cox regression analysis yielded adjusted hazard ratios for risk of colectomy in IFX-treated patients of 11.2 (95% confidence interval [CI] 2.4-53.1, P = 0.002) at 3 months and of 3.0 (95% CI 1.1-8.2, P = 0.030) at 12 months in comparison with CsA-treated patients. There were no opportunistic infections or mortality. Conclusions: Colectomy frequencies were significantly lower after rescue therapy with CsA than with a single infusion of IFX both at 3 and 12 months' follow-up. The superiority of CsA was seen principally during the first 15 days.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

Nyckelord

Ulcerative colitis
cyclosporine
infliximab
rescue therapy
colectomy
Medicine
Medicin
Medicinsk vetenskap
ulcerative colitis
cyclosporine
infliximab
rescue therapy
colectomy
MEDICINE

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