Colon salvage therapy for acute severe colitis: Cyclosporine or infliximab?

Current Opinion in Gastroenterology

Volumn 27, Issue 4, 2011, Pages 358-362

  Burger, Daniel C ^a   Travis, Simon ^a  

^a JOHN RADCLIFFE HOSPITAL   (United Kingdom)

Author keywords

acute severe colitis; cyclosporine; infliximab

Indexed keywords

AZATHIOPRINE; BETAMETHASONE; C REACTIVE PROTEIN; CALGRANULIN; CORTICOSTEROID; CYCLOSPORIN; INFLIXIMAB; LACTOFERRIN;

ACUTE SEVERE COLITIS; COLITIS; COLON RESECTION; DISEASE ASSOCIATION; DRUG BLOOD LEVEL; FECES ANALYSIS; GENE EXPRESSION; GENOTYPE; HEMATOCHEZIA; HUMAN; MORBIDITY; MORTALITY; PATIENT CARE; PREDICTION; REVIEW; SALVAGE THERAPY; SINGLE DRUG DOSE; SINGLE NUCLEOTIDE POLYMORPHISM; TREATMENT DURATION; TREATMENT OUTCOME; TREATMENT RESPONSE; ULCERATIVE COLITIS;

ACUTE DISEASE; ANTI-INFLAMMATORY AGENTS; ANTIBODIES, MONOCLONAL; COLITIS, ULCERATIVE; CYCLOSPORINE; HUMANS; IMMUNOSUPPRESSIVE AGENTS; SALVAGE THERAPY;

EID: 79958779730     PISSN: 02671379     EISSN: 15317056     Source Type: Journal    
DOI: 10.1097/MOG.0b013e32834586e3     Document Type: Review

References (36)

1. Dinesen LC, Walsh AJ, Protic MN, et al. The pattern and outcome of acute severe colitis. J Crohns Colitis 2010; 4:431-437. This demonstrated that 25% of all patients with ulcerative colitis will experience at least one episode of ASC, with the likelihood of colectomy being related to the biological severity on admission.
2. Turner D, Travis SP, Griffiths AM, et al. Consensus for managing acute severe ulcerative colitis in children: a systematic review and joint statement from ECCO, ESPGHAN, and the Porto IBD working group of ESPGHAN. Am J Gastroenterol 2011 [Epub ahead of print].
3. Van Assche G, Vermeire S, Rutgeerts P. Management of acute severe ulcerative colitis. Gut 2011; 60:130-133.
4. Hart AL, Ng SC. Review article: the optimal medical management of acute severe ulcerative colitis. Aliment Pharmacol Ther 2010; 32:615-627.
5. Kornbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol 2010; 105:501-523; quiz 24.
6. Laharie D, Bourreille A, Branche J, et al. Cyclosporin versus infliximab in severe acute ulcerative colitis refractory to intravenous steroids: a randomized study. J Crohns Colitis 2011; 5:S8.
7. Arnott ID, Leiper K, Down C, et al. 763 Outcome of acute severe ulcerative colitis: data from the UK National IBD Audit. Gastroenterology 2010; 138 (5 Supplement 1):S-106.
8. Nicholls RJ, Clark DN, Kelso L, et al. Nationwide linkage analysis in Scotland implicates age as the critical overall determinant of mortality in ulcerative colitis. Aliment Pharmacol Ther 2010; 31:1310-1321. Scottish nationwide linkage analysis that confirms age more than 65 years is the strongest determinant of 3-year mortality following hospital admission in ulcerative colitis patients.
9. Travis S, Satsangi J, Lemann M. Predicting the need for colectomy in severe ulcerative colitis: a critical appraisal of clinical parameters and currently available biomarkers. Gut 2011; 60:3-9.
10. Turner D, Walsh CM, Steinhart AH, Griffiths AM. Response to corticosteroids in severe ulcerative colitis: a systematic review of the literature and a meta-regression. Clin Gastroenterol Hepatol 2007; 5:103-110. (Pubitemid 46096828)
11. Turner D, Mack D, Leleiko N, et al. Severe pediatric ulcerative colitis: a prospective multicenter study of outcomes and predictors of response. Gastroenterology 2010; 138:2282-2291. This study examined 128 children across 10 pediatric centres: a PUCAI greater than 45 on day 3 and 5 of steroid therapy reliably predicts patients requiring rescue therapy. It also showed that infliximab is effective in steroid-refractory pediatric ulcerative colitis.
12. Kabakchiev B, Turner D, Hyams J, et al. Gene expression changes associated with resistance to intravenous corticosteroid therapy in children with severe ulcerative colitis. PLoS One 2010; 5:pii:e13085.
13. Haritunians T, Taylor KD, Targan SR, et al. Genetic predictors of medically refractory ulcerative colitis. Inflamm Bowel Dis 2010; 16:1830-1840.
14. Ho GT, Lee HM, Brydon G, et al. Fecal calprotectin predicts the clinical course of acute severe ulcerative colitis. Am J Gastroenterol 2009; 104:673-678.
15. Turner D, Leach ST, Mack D, et al. Faecal calprotectin, lactoferrin, M2-pyruvate kinase and S100A12 in severe ulcerative colitis: a prospective multicentre comparison of predicting outcomes and monitoring response. Gut 2010; 59:1207-1212. This study demonstrated that a simple clinical index (PUCAI), performed better than fecal markers in predicting outcome following a course of intravenous steroids for severe ulcerative colitis.
16. Hafeez R, Punwani S, Pendse D, et al. Derivation of a T2-weighted MRI total colonic inflammation score (TCIS) for assessment of patients with severe acute inflammatory colitis-a preliminary study. Eur Radiol 2011; 21:366-377. A preliminary study demonstrating that colonic MRI markers of inflammation correlate with CRP and stool frequency.
17. da Luz Moreira A, Vogel JD, Baker M, et al. Does CT influence the decision to perform colectomy in patients with severe ulcerative colitis? J Gastrointest Surg 2009; 13:504-507.
18. Sharkey L, Bredin F, Nightingale A, Parkes M. The use of cyclosporin A in acute steroid-refractory ulcerative colitis: long term outcomes. J Crohns Colitis (in press).
19. Walch A, Meshkat M, Vogelsang H, et al. Long-term outcome in patients with ulcerative colitis treated with intravenous cyclosporine A is determined by previous exposure to thiopurines. J Crohns Colitis 2010; 4:398-404.
20. Moskovitz DN, Van Assche G, Maenhout B, et al. Incidence of colectomy during long-term follow-up after cyclosporine-induced remission of severe ulcerative colitis. Clin Gastroenterol Hepatol 2006; 4:760-765. (Pubitemid 43833506)
21. Bamba S, Tsujikawa T, Inatomi O, et al. Factors affecting the efficacy of cyclosporin A therapy for refractory ulcerative colitis. J Gastroenterol Hepatol 2010; 25:494-498.
22. Gustavsson A, Jarnerot G, Hertervig E, et al. Clinical trial: colectomy after rescue therapy in ulcerative colitis - 3-year follow-up of the Swedish-Danish controlled infliximab study. Aliment Pharmacol Ther 2010; 32:984-989. This study demonstrated that the benefit of rescue therapy with a single dose of infliximab in steroid-refractory acute ulcerative colitis is maintained after 3 years. Also mucosal healing at 3 months was associated with a lower rate of colectomy.
23. Monterubbianesi R, Daperno M, Armuzzi A, et al. W1257 Infliximab for severe ulcerative colitis: short-term and one year outcome of three dose regimen. An Italian multicentre open-label study. Gastroenterology 2010; 138 (5 Supplement 1):S-685.
24. Seow CH, Newman A, Irwin SP, et al. Trough serum infliximab: a predictive factor of clinical outcome for infliximab treatment in acute ulcerative colitis. Gut 2010; 59:49-54. This study demonstrated that detectable trough serum infliximab predicts clinical remission, endoscopic improvement and a lower risk of colectomy, irrespective of antibody status.
25. Yang Z, Wu Q, Wu K, Fan D. Meta-analysis: preoperative infliximab treatment and short-term postoperative complications in patients with ulcerative colitis. Aliment Pharmacol Ther 2010; 31:486-492.
26. Coquet-Reinier B, Berdah SV, Grimaud JC, et al. Preoperative infliximab treatment and postoperative complications after laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis: a case-matched study. Surg Endosc 2010; 24:1866-1871.
27. Bossa F, Caruso N, Accadia L, et al. P127 - Oral cyclosporin vs in fliximab in patients with severe ulcerative colitis refractory to iv steroids. Preliminary data of a controlled, randomized study. J Crohns Colitis 2009; 3:S61-S70.
28. Spiegel BM, Ho W, Esrailian E, et al. Controversies in ulcerative colitis: a survey comparing decision making of experts versus community gastroenterologists. Clin Gastroenterol Hepatol 2009; 7:168-174. Survey study, which demonstrated most community gastroenterologists and ulcerative colitis specialists in the United States favor infliximab over cyclosporine in steroid-refractory inpatient ulcerative colitis.
29. Leblanc S, Allez M, Seksik P, et al. Successive treatment with cyclosporine and infliximab in severe ulcerative colitis (UC). Gastroenterology 2009; 136 (5 Supplement 1):A-88.
30. Herrlinger KR, Barthel DN, Schmidt KJ, et al. Infliximab as rescue medication for patients with severe ulcerative/indeterminate colitis refractory to tacrolimus. Aliment Pharmacol Ther 2010; 31:1036-1041.
31. Randall J, Singh B, Warren BF, et al. Delayed surgery for acute severe colitis is associated with increased risk of postoperative complications. Br J Surg 2010; 97:404-409.
32. Cahill RA, Lindsey I, Jones O, et al. Single-port laparoscopic total colectomy for medically uncontrolled colitis. Dis Colon Rectum 2010; 53:1143-1147. This paper describes successful total colectomy and end-ileostomy formation by a single-port laparoscopic approach in three patients with medical refractory colitis.
33. Holubar SD, Larson DW, Dozois EJ, et al. Minimally invasive subtotal colectomy and ileal pouch-anal anastomosis for fulminant ulcerative colitis: a reasonable approach? Dis Colon Rectum 2009; 52:187-192.
34. Jarnerot G, Hertervig E, Friis-Liby I, et al. Infliximab as rescue therapy in severe to moderately severe ulcerative colitis: a randomized, placebo-controlled study. Gastroenterology 2005; 128:1805-1811. (Pubitemid 40824691)
35. Lichtiger S, Present DH, Kornbluth A, et al. Cyclosporine in severe ulcerative colitis refractory to steroid therapy. N Engl J Med 1994; 330:1841-1845. (Pubitemid 24188135)
36. Van Assche G, D'Haens G, Noman M, et al. Randomized, double-blind comparison of 4 mg/kg versus 2 mg/kg intravenous cyclosporine in severe ulcerative colitis. Gastroenterology 2003; 125:1025-1031. (Pubitemid 37193449)