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


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Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
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Better 6 months outcome for steroid refractory ulcerative colitis with infliximab rescue therapy compared to tacrolimus or cyclosporine: a Swiss IBD cohort retrospective analysis
Titre de la conférence
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
Protic M., Schoepfer A., Frei P., Juillerat P., Mottet C., Mwinyi J., Rogler G., Vavricka S.R., Seibold F
Interlaken, Switzerland, September 20-21, 2012
Statut éditorial
Date de publication
Swiss Medical Weekly
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
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.
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.
Création de la notice
14/02/2013 16:13
Dernière modification de la notice
20/08/2019 14:00
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