Better 6 months outcome for steroid refractory ulcerative colitis with infliximab rescue therapy compared to tacrolimus or cyclosporine: a Swiss IBD cohort retrospective analysis

Details

Serval ID
serval:BIB_4C0D7ED60FA3
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Better 6 months outcome for steroid refractory ulcerative colitis with infliximab rescue therapy compared to tacrolimus or cyclosporine: a Swiss IBD cohort retrospective analysis
Title of the conference
Annual Meeting of the Swiss Society of Gastroenterology, Swiss Society of Visceral Surgery, Swiss Association of the Study of the Liver and Swiss Society of Clinical Nutrition
Author(s)
Protic M., Schoepfer A., Frei P., Juillerat P., Mottet C., Mwinyi J., Rogler G., Vavricka S.R., Seibold F
Address
Interlaken, Switzerland, September 20-21, 2012
ISBN
1424-7860
ISSN-L
0036-7672
Publication state
Published
Issued date
2012
Volume
142
Series
Swiss Medical Weekly
Pages
S6
Language
english
Abstract
BACKGROUND: C iclosporine ( CsA), Tacrolimus (Tcl) and
Infliximab (IFX) are effective rescue therapies in steroidrefractory
ulcerative colitis (UC). Comparative studies are
however m issing. M ETHOD: T his i s the retrospective
analysis of treatment outcome for oral Tcl (n=27, initially
0.05mg/Kg twice daily, aiming for serum trough levels of
5-10 n g/mL), i ntravenous C sA ( n=23, 2 mg/kg/daily a nd
then o ral CsA 5mg/kg/daily) and IFX ( n=43, 5 mg/kg
intravenously at week 0, 2, 6 and then every 8 weeks) in
patients with s teroid r efractory moderate to s evere UC
enrolled i n the SWISS IBD cohort s tudy. After successful
rescue therapy with Tcl o r C sA, t hiopurine m aintenance
therapy or maintenance therapy with Tcl (in Tcl pretreated
patients) was introduced. The endpoints analyzed steroid
free r emission r ate (on the basis of m odified Truelove-
Witts severity index (MTWSI)) and number of colectomies
after 6 m onths. R ESULTS: A t 6 months, 26% ( 7/27) o f
patients treated with T cl r emained i n steroid free
remission (MTWSI score ≤4) compared to 30 % (7/23) on
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droplets to the same extend under the linoleic acid treat, whereas lipid hydrolysis or loss was
significantly increased in Huh-7 WT cells after 24h.
Conclusions: Chronic alcohol feeding in obese, insulin-resistant rats exerts significant and
synergistic effects on PNPLA3 mRNA expression, which correlated with triglyceride content.
In v itro experiments suggest that PNPLA3 expression depends on the t ypes of d ietary f atty
acids with polyunsaturated fatty a cids i nducing a nd monounsaturated fatty a cids inhibiting
PNPLA3 mRNA. I148M polymorphism of PNPLA3 l eads to attenuation o f lipolytic
processes resulting in fat accumulation in the cell.
20
CsA and 58% ( 27/41) o f patients t reated w ith IFX ( Tcl &
CsA vs I FX p = 0 .018). S ignificant m ore patients had
primary non response, loss of response or severe adverse
events i n the CsA cohort ( 61%, 1 4/23) c ompared to Tcl
cohort (33.3 % , 9/27), and IFX cohort (30%, 1 3/43) (p=
0.037). Colectomy rate was significantly higher after CsA
(17.4 %, 4/23) compared to Tcl (3.7 %, 1/27) or IFX (2.3 %,
1/43) (p= 0.047).CONCLUSION: After s ix m onth, rescue
therapy with I FX h ad t he l owest c olectomy r ate,
significantly h igher steroid free r emission rate, a nd t he
lowest rate of non-response, loss of response and severe
adverse events compared to CsA or Tcl rescue treatment.
Create date
14/02/2013 16:13
Last modification date
20/08/2019 14:00
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