Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16681
Title: Examining maintenance care following infliximab salvage therapy for acute severe ulcerative colitis
Austin Authors: Seah, Dean ;Choy, Matthew C ;Gorelik, Alexandra;Connell, William R;Sparrow, Miles P;van Langenberg, Daniel;Hebbard, Geoffrey;Moore, Gregory;De Cruz, Peter
Affiliation: Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Academic Centre, University of Melbourne, Melbourne, Victoria, Australia
Melbourne EpiCentre, Melbourne Health, Melbourne, Victoria, Australia
Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia
Department of Medicine, Monash University, Melbourne, Victoria, Australia
Department of Gastroenterology, Eastern Health, Melbourne, Victoria, Australia
Department of Gastroenterology, Melbourne Health, Melbourne, Victoria, Australia
Department of Gastroenterology, Monash Health, Melbourne, Victoria, Australia
Issue Date: Jan-2018
Publication information: Journal of Gastroenterology and Hepatology 2018; 33(1): 226-231
Abstract: BACKGROUND AND AIMS: Data supporting the optimal maintenance drug therapy & strategy to monitor ongoing response following successful infliximab (IFX) induction, for acute severe ulcerative colitis (ASUC), are limited. We aimed to evaluate maintenance & monitoring strategies employed in patients post IFX induction therapy. METHODS: Patients in 6 Australian tertiary centres treated with IFX for steroid-refractory ASUC between April 2014 & May 2015 were identified via hospital IBD & pharmacy databases. Patients were followed-up for 1 year with clinical data over 12 months recorded. Analysis was limited to patient outcomes beyond 3 months. RESULTS: 41 patients were identified. 5/41 (12%) patients underwent colectomy within 3 months and 1 patient was lost to follow-up. 6/35 (17%) of the remaining patients progressed to colectomy by 12 months. MAINTENANCE THERAPY: Patients maintained on thiopurine monotherapy (14/35) vs. IFX/thiopurine therapy (15/35) were followed up. 2/15 (13%) patients who received combination maintenance therapy underwent a colectomy at 12 months, compared with 1/14 (7%) patients receiving thiopurine monotherapy (p=0.610). MONITORING DURING MAINTENANCE: Post-discharge, thiopurine metabolites were monitored in 15/27 (56%); faecal calprotectin in 11/32 (34%); & serum IFX levels in 4/20 (20%). 20/32 (63%) patients had an endoscopic evaluation after IFX salvage with median time to 1st endoscopy of 109 days (IQR 113-230). CONCLUSION: Following IFX induction therapy for ASUC, the uptake of maintenance therapy in this cohort & strategies to monitor ongoing response were variable. These data suggest that the optimal maintenance & monitoring strategy post IFX salvage therapy remains to be defined.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16681
DOI: 10.1111/jgh.13850
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/28618062
Type: Journal Article
Subjects: Acute Severe Ulcerative Colitis
Infliximab
Maintenance Therapy
Monitoring
Thiopurine
Appears in Collections:Journal articles

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