Löwenberg Mark, Duijvis Nicolette W, Ponsioen Cyriel, van den Brink Gijs R, Fockens Paul, D'Haens Geert R A M
aDepartment of Gastroenterology and Hepatology bTytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands.
Eur J Gastroenterol Hepatol. 2014 Nov;26(11):1240-6. doi: 10.1097/MEG.0000000000000187.
Cyclosporine and infliximab (IFX) seem equally effective as rescue therapy in hospitalized patients with severe ulcerative colitis (UC), although associated hospital stay and costs may differ.
The aim of this study was to compare the duration of hospital stay and associated costs from initiation of rescue therapy to time of discharge in hospitalized patients with corticosteroid-refractory UC receiving cyclosporine or IFX. Colectomy rates after 6 months were used as the outcome parameter for treatment success.
Hospital records of patients admitted between November 2003 and August 2012 at a tertiary referral center were analyzed.
Forty-two patients were included (cyclosporine group: 26 patients; IFX group: 16 patients). Patient characteristics were comparable, with the exception that cyclosporine-treated patients more often had a pancolitis (89 vs. 63%, P=0.046). The median length of hospital stay was 11.0 (interquartile range 7.75-13.25) versus 4.0 days (interquartile range 4.0-5.75) in the cyclosporine and IFX group (P<0.01), respectively. The mean in-hospital costs were significantly higher in the cyclosporine-treated versus IFX-treated patients (6121 vs. 4853 euros, P<0.05), whereas the total costs up to 3 months after initiation of rescue therapy were significantly higher in the IFX group (6787 vs. 9983 euros, P<0.01). There were no significant differences in colectomy rates at 6 months (23 and 31% for cyclosporine and IFX, P=0.50). More side-effects were observed during treatment with cyclosporine.
Length of hospital stay and in-hospital costs have been reduced significantly since the introduction of IFX as rescue therapy for severe UC instead of cyclosporine. However, the total treatment costs are higher in IFX-treated patients.
环孢素和英夫利昔单抗（IFX）在重症溃疡性结肠炎（UC）住院患者的挽救治疗中似乎同样有效，尽管相关住院时间和费用可能有所不同。
本研究旨在比较接受环孢素或IFX治疗的糖皮质激素难治性UC住院患者从开始挽救治疗到出院的住院时间及相关费用。6个月后的结肠切除术率用作治疗成功的结局参数。
分析了2003年11月至2012年8月在一家三级转诊中心住院患者的医院记录。
纳入42例患者（环孢素组：26例患者；IFX组：16例患者）。患者特征具有可比性，不同之处在于接受环孢素治疗的患者全结肠炎更为常见（89%对63%，P=0.046）。环孢素组和IFX组的中位住院时间分别为11.0天（四分位间距7.75 - 13.25）和4.0天（四分位间距4.0 - 5.75）（P<0.01）。环孢素治疗患者的平均住院费用显著高于IFX治疗患者（6121欧元对4853欧元，P<0.05），而挽救治疗开始后3个月内的总费用在IFX组显著更高（6787欧元对9983欧元，P<0.01）。6个月时结肠切除术率无显著差异（环孢素组和IFX组分别为23%和31%，P=0.50）。环孢素治疗期间观察到更多副作用。
自将IFX作为重症UC的挽救治疗而非环孢素引入以来，住院时间和住院费用已显著降低。然而，IFX治疗患者的总治疗费用更高。
