Effectiveness and safety of a third-line rescue treatment for acute severe ulcerative colitis refractory to infliximab or ciclosporin (REASUC study)
© 2024 John Wiley & Sons Ltd..
BACKGROUND: The advent of new therapeutic agents and the improvement of supporting care might change the management of acute severe ulcerative colitis (ASUC) and avoid colectomy.
AIMS: To evaluate the colectomy-free survival and safety of a third-line treatment in patients with ASUC refractory to intravenous steroids and who failed either infliximab or ciclosporin.
METHODS: Multicentre retrospective cohort study of patients with ASUC refractory to intravenous steroids who had failed infliximab or ciclosporin and received a third-line treatment during the same hospitalisation. Patients who stopped second-line treatment due to disease activity or adverse events (AEs) were eligible. We assessed short-term colectomy-free survival by logistic regression analysis. Kaplan-Meier curves and Cox regression models were used for long-term assessment.
RESULTS: Among 78 patients, 32 received infliximab and 46 ciclosporin as second-line rescue treatment. Third-line treatment was infliximab in 45 (58%), ciclosporin in 17 (22%), tofacitinib in 13 (17%) and ustekinumab in 3 (3.8%). Colectomy was performed in 29 patients (37%) during follow-up (median 21 weeks). Of the 78 patients, 32 and 18 were in clinical remission at, respectively, 12 and 52 weeks. At the last visit, 25 patients were still on third-line rescue treatment, while 12 had stopped it due to clinical remission. AEs were reported in 26 (33%) patients. Two patients died (2.6%), including one following colectomy.
CONCLUSION: Third-line rescue treatment avoided colectomy in over half of the patients with ASUC and may be considered a therapeutic strategy.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:59 |
|---|---|
| Enthalten in: |
Alimentary pharmacology & therapeutics - 59(2024), 10 vom: 20. Apr., Seite 1248-1259 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
García, María José [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
83HN0GTJ6D |
|---|
| Anmerkungen: |
Date Completed 23.04.2024 Date Revised 23.04.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/apt.17938 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369356187 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369356187 | ||
| 003 | DE-627 | ||
| 005 | 20240424232022.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240306s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/apt.17938 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1385.xml |
| 035 | |a (DE-627)NLM369356187 | ||
| 035 | |a (NLM)38445785 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a García, María José |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effectiveness and safety of a third-line rescue treatment for acute severe ulcerative colitis refractory to infliximab or ciclosporin (REASUC study) |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 23.04.2024 | ||
| 500 | |a Date Revised 23.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: The advent of new therapeutic agents and the improvement of supporting care might change the management of acute severe ulcerative colitis (ASUC) and avoid colectomy | ||
| 520 | |a AIMS: To evaluate the colectomy-free survival and safety of a third-line treatment in patients with ASUC refractory to intravenous steroids and who failed either infliximab or ciclosporin | ||
| 520 | |a METHODS: Multicentre retrospective cohort study of patients with ASUC refractory to intravenous steroids who had failed infliximab or ciclosporin and received a third-line treatment during the same hospitalisation. Patients who stopped second-line treatment due to disease activity or adverse events (AEs) were eligible. We assessed short-term colectomy-free survival by logistic regression analysis. Kaplan-Meier curves and Cox regression models were used for long-term assessment | ||
| 520 | |a RESULTS: Among 78 patients, 32 received infliximab and 46 ciclosporin as second-line rescue treatment. Third-line treatment was infliximab in 45 (58%), ciclosporin in 17 (22%), tofacitinib in 13 (17%) and ustekinumab in 3 (3.8%). Colectomy was performed in 29 patients (37%) during follow-up (median 21 weeks). Of the 78 patients, 32 and 18 were in clinical remission at, respectively, 12 and 52 weeks. At the last visit, 25 patients were still on third-line rescue treatment, while 12 had stopped it due to clinical remission. AEs were reported in 26 (33%) patients. Two patients died (2.6%), including one following colectomy | ||
| 520 | |a CONCLUSION: Third-line rescue treatment avoided colectomy in over half of the patients with ASUC and may be considered a therapeutic strategy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Infliximab |2 NLM | |
| 650 | 7 | |a B72HH48FLU |2 NLM | |
| 650 | 7 | |a Cyclosporine |2 NLM | |
| 650 | 7 | |a 83HN0GTJ6D |2 NLM | |
| 650 | 7 | |a Gastrointestinal Agents |2 NLM | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 700 | 1 | |a Riestra, Sabino |e verfasserin |4 aut | |
| 700 | 1 | |a Amiot, Aurelien |e verfasserin |4 aut | |
| 700 | 1 | |a Julsgaard, Mette |e verfasserin |4 aut | |
| 700 | 1 | |a García de la Filia, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Calafat, Margalida |e verfasserin |4 aut | |
| 700 | 1 | |a Aguas, Mariam |e verfasserin |4 aut | |
| 700 | 1 | |a de la Peña, Luisa |e verfasserin |4 aut | |
| 700 | 1 | |a Roig, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Caballol, Berta |e verfasserin |4 aut | |
| 700 | 1 | |a Casanova, María José |e verfasserin |4 aut | |
| 700 | 1 | |a Farkas, Klaudia |e verfasserin |4 aut | |
| 700 | 1 | |a Boysen, Trine |e verfasserin |4 aut | |
| 700 | 1 | |a Bujanda, Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Cuarán, Camila |e verfasserin |4 aut | |
| 700 | 1 | |a Dobru, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Fousekis, Fotios |e verfasserin |4 aut | |
| 700 | 1 | |a Gargallo-Puyuelo, Carla Jerusalén |e verfasserin |4 aut | |
| 700 | 1 | |a Savarino, Edoardo |e verfasserin |4 aut | |
| 700 | 1 | |a Calvet, Xavier |e verfasserin |4 aut | |
| 700 | 1 | |a Huguet, José María |e verfasserin |4 aut | |
| 700 | 1 | |a Kupcinskas, Limas |e verfasserin |4 aut | |
| 700 | 1 | |a López-Cardona, Julia |e verfasserin |4 aut | |
| 700 | 1 | |a Raine, Tim |e verfasserin |4 aut | |
| 700 | 1 | |a van Oostrom, Joep |e verfasserin |4 aut | |
| 700 | 1 | |a Gisbert, Javier P |e verfasserin |4 aut | |
| 700 | 1 | |a Chaparro, María |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Alimentary pharmacology & therapeutics |d 1992 |g 59(2024), 10 vom: 20. Apr., Seite 1248-1259 |w (DE-627)NLM012692506 |x 1365-2036 |7 nnns |
| 773 | 1 | 8 | |g volume:59 |g year:2024 |g number:10 |g day:20 |g month:04 |g pages:1248-1259 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/apt.17938 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 59 |j 2024 |e 10 |b 20 |c 04 |h 1248-1259 | ||