Yamamoto-Furusho Jesús K, Uzcanga Luis F
Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Dig Surg. 2008;25(5):383-6. doi: 10.1159/000170882. Epub 2008 Nov 13.
Infliximab therapy is effective for the induction and maintenance of clinical remission in patients with moderate to severe ulcerative colitis. However, it has not been studied extensively in hospitalized patients who require colectomy as a rescue therapy for severe ulcerative colitis refractory to intravenous corticosteroids.
To evaluate the effectiveness of infliximab in hospitalized patients with severe ulcerative colitis refractory to intravenous corticoids as a rescue therapy before colectomy.
10 severe ulcerative colitis patients refractory to intravenous hydrocortisone administered for at least 7 days and candidate for colectomy were selected to receive a single infusion of infliximab (5 mg/kg).
8 patients failed to respond to infliximab and required colectomy during the hospitalization period. The median time to operation after infliximab infusion was 21 days. Of 8 patients, 6 had a partial clinical response manifested by a decreasing number of bowel movements and rectal bleeding during 7-14 days after the infliximab infusion, and the remaining 2 patients showed a lack of response to infliximab infusion.
These results suggest that a single infliximab infusion seems to be ineffective as a rescue therapy of colectomy in hospitalized patients with severe ulcerative colitis refractory to systemic corticosteroids.
英夫利昔单抗疗法对中度至重度溃疡性结肠炎患者诱导和维持临床缓解有效。然而，对于因严重溃疡性结肠炎对静脉注射皮质类固醇难治而需要行结肠切除术作为挽救治疗的住院患者，尚未进行广泛研究。
评估英夫利昔单抗在因严重溃疡性结肠炎对静脉皮质类固醇难治而需在结肠切除术前行挽救治疗的住院患者中的有效性。
选择10例对静脉注射氢化可的松治疗至少7天无效且拟行结肠切除术的严重溃疡性结肠炎患者，接受单次英夫利昔单抗（5mg/kg）输注。
8例患者对英夫利昔单抗无反应，在住院期间需要行结肠切除术。英夫利昔单抗输注后至手术的中位时间为21天。8例患者中，6例在英夫利昔单抗输注后7-14天出现部分临床反应，表现为排便次数和直肠出血减少，其余2例患者对英夫利昔单抗输注无反应。
这些结果表明，单次英夫利昔单抗输注作为对全身皮质类固醇难治的严重溃疡性结肠炎住院患者结肠切除术的挽救治疗似乎无效。
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