Our aim was to evaluate the efficacy and safety of infliximab and cyclosporine in this clinical scenario. Methods: A retrospective review of inpatients with severe, steroid-refractory UC, who were admitted to The Royal Melbourne Hospital between January 2003 and December 2013, was conducted. The primary end-point was time to colectomy at 12 months. Secondary end-points were C-Reactive protein (CRP) levels and number of stools/day for the first 7 days of
rescue therapy, time to discharge from initiation of rescue therapy, hospitalization for UC up to 12 months following discharge find more and documented adverse events. Results: 28 cases of severe, steroid-refractory UC requiring rescue therapy were analyzed, with 15 cases in the cyclosporine group and 13 cases in the infliximab group. By 12 months, the colectomy
rate was 33% (5/15) for those receiving cyclosporine and 31% (4/13) for those on infliximab (p = 0.871). There was no difference in the number of stools/day and CRP levels between cyclosporine and infliximab over the first 7 days of treatment. Patients receiving infliximab stayed in hospital a median of 4 days less than those on cyclosporine (p = 0.006). 30% (3/10) of cyclosporine-treated patients and 10% (1/10) of infliximab-treated patients were re-hospitalized for UC after successful rescue therapy initially. There were more adverse events associated selleck products with cyclosporine but this was non-significant (p = 0.136). Conclusion: Infliximab is as safe and effective as cyclosporine in treating severe, steroid-refractory UC. Infliximab leads to a shorter duration of hospital stay after initiation of treatment. Colectomy rates were the same for both drugs at 12 months. 1. Laharie D, Bourreille A, Branche J, et al. Ciclosporin versus infliximab in patients with severe ulcerative colitis refractory to intravenous steroids: a parallel, open-label randomized controlled trial. Lancet. 2012; 380: 1909–1915. MCS CHOY,1 AC MURPHY,1 AE BLOCH,1 AJ THOMPSON,1 M LUST,1 SJ BROWN,1 EK WRIGHT,1 MA 上海皓元医药股份有限公司 KAMM,1 G ALEX,2 WR CONNELL,1 SJ BELL1 1Department of Gastroenterology,
St Vincent’s Hospital, Melbourne, Australia, 2Department of Gastroenterology, Royal Children’s Hospital, Melbourne, Australia Introduction and Aims: Natural history studies have shown that pediatric-onset inflammatory bowel disease (IBD) is characterized by extensive intestinal involvement and rapid disease progression. However, there is little data describing disease activity and clinical outcomes as individuals transition to adult care, a process that can be challenging as patients adopt responsibility for their own care as well as accept changes in care and service provision. We therefore evaluated our experience with transition patients referred to a large tertiary adult IBD clinic over the period 2004–2014.