Gut Liver.  2015 Sep;9(5):601-606. 10.5009/gnl14120.

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

• Kim EH
• Kim DH
• Park SJ
• Hong SP
• Kim TI
• Kim WH
• Cheon JH

• KMID: 2234065
• DOI: http://doi.org/10.5009/gnl14120

Abstract

BACKGROUND/AIMS
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.
METHODS
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.
RESULTS
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).
CONCLUSIONS
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.

Keyword

Colitis, ulcerative; Cyclosporine; Infliximab

MeSH Terms

Adrenal Cortex Hormones/therapeutic use
Adult
Aged
Azathioprine/therapeutic use
Colectomy/statistics & numerical data
Colitis, Ulcerative/*drug therapy
Cyclosporine/*therapeutic use
Drug Therapy, Combination
Female
Humans
Immunosuppressive Agents/*therapeutic use
Infliximab/*therapeutic use
Male
Middle Aged
Proportional Hazards Models
Republic of Korea
Retrospective Studies
Salvage Therapy/*methods
Treatment Outcome
Young Adult
Adrenal Cortex Hormones
Azathioprine
Cyclosporine
Immunosuppressive Agents
Infliximab