The effectiveness and safety of rescue treatments in 108 patients with steroid-refractory ulcerative colitis with sequential rescue therapies in a subgroup of patients.

Détails

ID Serval
serval:BIB_0EC12ECB30F2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
The effectiveness and safety of rescue treatments in 108 patients with steroid-refractory ulcerative colitis with sequential rescue therapies in a subgroup of patients.
Périodique
Journal of Crohn's and Colitis
Auteur(s)
Protic M., Seibold F., Schoepfer A., Radojicic Z., Juillerat P., Bojic D., Mwinyi J., Mottet C., Jojic N., Beglinger C., Vavricka S., Rogler G., Frei P.
ISSN
1876-4479 (Electronic)
ISSN-L
1873-9946
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
8
Numéro
11
Pages
1427-1437
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Résumé
BACKGROUND: Among patients with steroid-refractory ulcerative colitis (UC) in whom a first rescue therapy has failed, a second line salvage treatment can be considered to avoid colectomy.
AIM: To evaluate the efficacy and safety of second or third line rescue therapy over a one-year period.
METHODS: Response to single or sequential rescue treatments with infliximab (5mg/kg intravenously (iv) at week 0, 2, 6 and then every 8weeks), ciclosporin (iv 2mg/kg/daily and then oral 5mg/kg/daily) or tacrolimus (0.05mg/kg divided in 2 doses) in steroid-refractory moderate to severe UC patients from 7 Swiss and 1 Serbian tertiary IBD centers was retrospectively studied. The primary endpoint was the one year colectomy rate.
RESULTS: 60% of patients responded to the first rescue therapy, 10% went to colectomy and 30% non-responders were switched to a 2(nd) line rescue treatment. 66% of patients responded to the 2(nd) line treatment whereas 34% failed, of which 15% went to colectomy and 19% received a 3(rd) line rescue treatment. Among those, 50% patients went to colectomy. Overall colectomy rate of the whole cohort was 18%. Steroid-free remission rate was 39%. The adverse event rates were 33%, 37.5% and 30% for the first, second and third line treatment respectively.
CONCLUSION: Our data show that medical intervention even with 2(nd) and 3(rd) rescue treatments decreased colectomy frequency within one year of follow up. A longer follow-up will be necessary to investigate whether sequential therapy will only postpone colectomy and what percentage of patients will remain in long-term remission.
Pubmed
Web of science
Open Access
Oui
Création de la notice
06/03/2015 12:11
Dernière modification de la notice
20/08/2019 12:35
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