Article
Gastroenterology & Hepatology
Eun Mi Song, Eun Hye Oh, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye
Summary: Through retrospective review of 121 Korean patients with SR-ASUC, it was found that there were no significant differences in the rates of treatment failure and colectomy at 3 months between the CsA and IFX treatment groups. Additionally, prior use of azathioprine and Mayo score at the time of rescue therapy were both associated with treatment failure or colectomy within 3 months.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Article
Gastroenterology & Hepatology
David Laharie, Arnaud Bourreille, Julien Branche, Matthieu Allez, Yoram Bouhnik, Jerome Filippi, Frank Zerbib, Guillaume Savoye, Lucine Vuitton, Jacques Moreau, Aurelien Amiot, Laurent Beaugerie, Elena Ricart, Olivier Dewit, Antonio Lopez-Sanroman, Mathurin Fumery, Franck Carbonnel, Anthony Buisson, Benoit Coffin, Xavier Roblin, Gert van Assche, Maria Esteve, Martti Farkkila, Javier P. Gisbert, Philippe Marteau, Stephane Nahon, Martine de Vos, Laurent Peyrin-Biroulet, Jean-Yves Mary
Summary: In patients with steroid-refractory ASUC responding to second-line medical therapy, the process of endoscopic remission started with bleeding remission and was not achieved in half the patients at day 98 for vascular pattern. Infliximab provided a higher endoscopic remission rate than cyclosporine at day 98.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Article
Gastroenterology & Hepatology
Gaurav Syal, Lori Robbins, Amir Kashani, Nirupama Bonthala, Edward Feldman, Phillip Fleshner, Eric Vasiliauskas, Dermot McGovern, Christina Ha, Stephan Targan, Gil Y. Melmed
Summary: Serum albumin and band neutrophil percentage are independent predictors of failure of infliximab rescue therapy in patients with acute severe ulcerative colitis. The combination of serum albumin <= 2.5 g/dl and band neutrophil count >= 13% has a 100% positive predictive value for 90-day colectomy.
DIGESTIVE DISEASES AND SCIENCES
(2021)
Article
Gastroenterology & Hepatology
Lori A. Zimmerman, Jonathan Spaan, Nathan Weinbren, Krishanth Manokaran, Aravindh Ajithkumar, Anna Bogursky, Enju Liu, Craig Lillehei, Brent R. Weil, Jill M. Zalieckas, Athos Bousvaros, Paul A. Rufo
Summary: This study retrospectively analyzed the outcomes of 170 pediatric patients with acute severe colitis (ASC) who were treated with either IFX or TAC after failing intravenous corticosteroids. The study found that there were no significant differences in the likelihood of colectomy 6 months after initiating IFX or TAC rescue therapy, and the efficacy of both agents was comparable. However, the types of adverse effects differed between the two therapies. These data support the use of either TAC or IFX in children with ASC refractory to intravenous corticosteroids.
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
(2023)
Article
Gastroenterology & Hepatology
Jeffrey A. Berinstein, Jessica L. Sheehan, Michael Dias, Elliot M. Berinstein, Calen A. Steiner, Laura A. Johnson, Randolph E. Regal, John I. Allen, Kelly C. Cushing, Ryan W. Stidham, Shrinivas Bishu, Jami A. R. Kinnucan, Shirley A. Cohen-Mekelburg, Akbar K. Waljee, Peter D. R. Higgins
Summary: The study suggests that tofacitinib with concomitant intravenous corticosteroids may reduce the risk of colectomy in ASUC patients, especially with a dosage of 10 mg three times daily. Rates of complications and steroid dependence were similar between the tofacitinib group and controls. Prospective trials are needed to further investigate the safety and optimal dosing of tofacitinib in ASUC patients.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Review
Medicine, General & Internal
Benjamin L. Gordon, Robert Battat
Summary: Therapeutic drug monitoring (TDM) is a useful strategy in ulcerative colitis (UC), particularly in acute severe UC (ASUC). While there is limited data available for the use of TDM of infliximab in ASUC, observational data suggest that higher serum infliximab concentrations and lower clearance are associated with better clinical outcomes and decreased rates of colectomy. However, more studies are needed to evaluate optimal dosing and TDM targets in this population.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Maia Kayal, Hannah Posner, Hadar Meringer Milwidsky, Michael Plietz, Sergey Khaitov, Patricia Sylla, Alexander Greenstein, Marla C. Dubinsky, Saurabh Mehandru, Jean Frederic Colombel
Summary: A retrospective cohort analysis of 416 patients found that acute severe ulcerative colitis was significantly associated with subsequent acute pouchitis. The risk of pouchitis may be influenced by immune activation and disease severity prior to colectomy.
INFLAMMATORY BOWEL DISEASES
(2023)
Review
Pharmacology & Pharmacy
Alix Demaris, Ella S. K. Widigson, Johan F. K. F. Ilvemark, Casper Steenholdt, Jakob B. Seidelin, Wilhelm Huisinga, Robin Michelet, Linda B. S. Aulin, Charlotte Kloft
Summary: This review aims to analyze the population PK models of infliximab (IFX) in patients with ulcerative colitis (UC) and acute severe UC (ASUC), and assess the impact of disease activity on IFX PK. The results showed that there are still many gaps in the current research, such as a limited number of models specifically developed for UC patients, a lack of studies on severe UC patients, and a lack of evaluation of predictive performance for the models. Therefore, more comprehensive research and adequate reporting and evaluation of the models are needed for clinical application.
Article
Gastroenterology & Hepatology
Robert Gilmore, Wei Lian Tan, Richard Fernandes, Yoon-Kyo An, Jakob Begun
Summary: This study found that upadacitinib may be a safe and effective salvage therapy for patients with steroid-refractory acute severe ulcerative colitis who have previously failed to respond to infliximab therapy. Prospective studies are needed to determine the safety and efficacy of upadacitinib use in this setting before routine use can be recommended.
JOURNAL OF CROHNS & COLITIS
(2023)
Review
Medicine, General & Internal
Yangyang Duan, Xueqi Wang, Qiubo Li, Shijiang Sun, Xi Liang, Huijing Li, Jing Huang, Tianhe Zhao, Jingnan Hu, Jianxin Liu, Zhenbiao Hu, Jianming He
Summary: Infliximab, cyclosporine, and tacrolimus are effective salvage therapies for ulcerative colitis. Tacrolimus has the highest efficacy in achieving long-term clinical remission, while cyclosporine is the most cost-effective option compared to infliximab or tacrolimus.
Article
Gastroenterology & Hepatology
D. Laharie, J. Y. Mary
Summary: This study aimed to quantify the association between achieving Mayo endoscopic sub-score (MES) of 0 or 1 and long-term disease outcome in patients with acute severe ulcerative colitis (ASUC). The results showed that patients who achieved complete endoscopic healing had better survival and longer time without disease relapse.
JOURNAL OF CROHNS & COLITIS
(2023)
Article
Cardiac & Cardiovascular Systems
Xuhan Liu, Xia Peng, Chunyan Rong, Weihua Zhang
Summary: Patients with ulcerative colitis are prone to VTE and the use of corticosteroids increases the risk of thrombus. Anticoagulation strategy for patients with ulcerative colitis after gastrointestinal bleeding is a topic for discussion.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Medicine, General & Internal
Myriam Renaud, Ahmet Ayav, Benedicte Caron, Laurent Peyrin-Biroulet, Adeline Germain
Summary: This retrospective study investigated the safety and feasibility of Hartmann's pouch surgery in the treatment of patients with acute severe ulcerative colitis. The results showed that Hartmann's pouch surgery has low rates of complications and pelvic sepsis, and can successfully restore intestinal continuity.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Gastroenterology & Hepatology
Shomron Ben-Horin, Ofir Har-Noy, Konstantinos H. Katsanos, Xavier Roblin, Minhu Chen, Xiang Gao, Doron Schwartz, Jae Hee Cheon, Monica Cesarini, Daniela Bojic, Marijana Protic, Angeliki Theodoropoulou, Heba Abu-Kaf, Tal Engel, Jian Tang, Pauline Veyrard, Xiaoqing Lin, Ren Mao, Dimitrios Christodoulou, Konstantinos Karmiris, Tamara Knezevic-Ivanovski
Summary: In this randomized controlled trial, the combination of mesalamine with corticosteroids did not show superior efficacy compared to corticosteroids alone in hospitalized patients with acute severe ulcerative colitis (ASUC). However, there was a potential indication that the need for biologics was reduced in the mesalamine group within 90 days.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2022)
Article
Gastroenterology & Hepatology
Robert Gilmore, Patrick Hilley, Ashish Srinivasan, Matthew Choy, Peter De Cruz
Summary: This study found that high-dose tofacitinib may have a role as salvage therapy in patients with steroid-refractory ASUC.
JOURNAL OF CROHNS & COLITIS
(2022)