Infliximab versus Cyclosporine Treatment for Severe Corticosteroid-Refractory Ulcerative Colitis: A Korean, Retrospective, Single Center Study

• Published in: Gut and liver 2015, 9(5), , pp.601-606
• Main Authors: Kim, Eun Hye, Kim, Duk Hwan, Park, Soo Jung, Hong, Sung Pil, Kim, Tae Il, Kim, Won Ho, Cheon, Jae Hee
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - therapeutic use; Adult; Aged; Azathioprine - therapeutic use; Colectomy - statistics & numerical data; colitis; Colitis, Ulcerative - drug therapy; cyclosporine; Cyclosporine - therapeutic use; Drug Therapy, Combination; Female; Humans; Immunosuppressive Agents - therapeutic use; infliximab; Infliximab - therapeutic use; Male; Middle Aged; Original; Proportional Hazards Models; Republic of Korea; Retrospective Studies; Salvage Therapy - methods; Treatment Outcome; ulcerative; Young Adult; 내과학
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl14120

In patients with corticosteroid-refractory ulcerative colitis (UC), cyclosporine or infliximab may be added to the treatment regimen to induce remission. Here, we aimed to compare the efficacy of cyclosporine and infliximab. Between January 1995 and May 2012, the medical records of 43 patients with corticosteroid-refractory UC who received either infliximab or cyclosporine as a rescue therapy at a tertiary care hospital in Korea were reviewed. Among the 43 patients, 10 underwent rescue therapy with cyclosporine and the remaining 33 patients received infliximab. A follow-up of 12 months was completed for all patients. The colectomy rate at 12 months was 30% and 3% in the cyclosporine and the infliximab groups, respectively (p=0.034). However, the Cox proportional hazard model indicated that the treatment of rescue therapy was not an independent associate factor for preventing colectomy (p=0.164). In the subgroup analysis, infliximab with azathioprine was superior to cyclosporine for preventing colectomy (hazard ratio of infliximab with azathioprine compared with cyclosporine only, 0.073; 95% confidence interval, 0.008 to 0.629). No difference between infliximab and cyclosporine with respect to preventing colectomy was noted. However, infliximab with azathioprine may be more effective than cyclosporine alone for preventing colectomy.