Infliximab as a Rescue Therapy for Hospitalized Patients with Severe Ulcerative Colitis Refractory to Systemic Corticosteroids

Abstract

Background: 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. Aim: To evaluate the effectiveness of infliximab in hospitalized patients with severe ulcerative colitis refractory to intravenous corticoids as a rescue therapy before colectomy. Methods: 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). Results: 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. Conclusion: 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.