Refractory Acute Severe Ulcerative Colitis Research Articles

Surgical outcomes in steroid refractory acute severe ulcerative colitis: the impact of rescue therapy

The advent of rescue medical therapy (cyclosporin or infliximab) and laparoscopic surgery has shifted the paradigm in managing steroid refractory acute severe ulcerative colitis (ASUC). We investigated prospectively the impact of rescue therapy on timing and postoperative complications of urgent colectomy and subsequent restorative surgery for steroid refractory ASUC. All consecutive presentations of steroid refractory ASUC at the Royal Brisbane Hospital (1996-2009) were entered in the study. Data collated included demographics, clinical and laboratory parameters on admission, medical therapy and operative and postoperative details. Steroid refractory ASUC patients undergoing immediate colectomy were compared with those failing rescue therapy and requiring same admission colectomy. Of 108 steroid refractory ASUC presentations, 19 (18%) received intravenous steroids only and proceeded directly to colectomy. Rescue medical therapy was instituted in 89 (82%) patients with 30 (34%) failing to respond and proceeding to colectomy. There was no significant difference in the median time from admission to colectomy for rescue therapy compared with steroid-only cases (12 vs 10 days, P = 0.70) or 30-day complication rates (27%vs 47%, P = 0.22). The interval from colectomy to a subsequent restorative procedure was significantly longer for patients who failed rescue therapy (12 vs 5 months, P = 0.02). Furthermore 30-day complications following pouch surgery were significantly higher in patients who failed rescue therapy (32%vs 0%, P = 0.01). Rescue therapy in steroid refractory ASUC is not related to delay in urgent colectomy or increased post-colectomy complications.

Sa1279 Long-Term Outcome of Treatment With Inflixiamb in Patients With Steroid Refractory Acute Severe Ulcerative Colitis

Sa1279 Long-Term Outcome of Treatment With Inflixiamb in Patients With Steroid Refractory Acute Severe Ulcerative Colitis

Rescue therapy for steroid refractory acute severe ulcerative colitis: More choice, better outcomes?

See article in J. Gastroenterol. Hepatol. 2012; 27: 487–492.

Infliximab rescue therapy for steroid refractory acute severe ulcerative colitis in the exeter ibd cohort

IntroductionInfliximab (IFX) has been shown to be efficacious in the treatment of steroid refractory acute severe ulcerative colitis (ASUC) with reduced rates of colectomy at index admission and at 3-year...