Evolution of Endoscopic Lesions in Steroid-Refractory Acute Severe Ulcerative Colitis Responding to Infliximab or Cyclosporine

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Laharie , D , Bourreille , A , Branche , J , Allez , M , Bouhnik , Y , Filippi , J , Zerbib , F , Savoye , G , Vuitton , L , Moreau , J , Amiot , A , Beaugerie , L , Ricart , E , Dewit , O , Lopez-Sanroman , A , Fumery , M , Carbonnel , F , Buisson , A , Coffin , B , Roblin , X , van Assche , G , Esteve , M , Färkkilä , M , Gisbert , J P , Marteau , P , Nahon , S , de Vos , M , Peyrin-Biroulet , L & Mary , J-Y 2021 , ' Evolution of Endoscopic Lesions in Steroid-Refractory Acute Severe Ulcerative Colitis Responding to Infliximab or Cyclosporine ' , Clinical Gastroenterology and Hepatology , vol. 19 , no. 6 , pp. 1180-+ . https://doi.org/10.1016/j.cgh.2020.08.001

Title: Evolution of Endoscopic Lesions in Steroid-Refractory Acute Severe Ulcerative Colitis Responding to Infliximab or Cyclosporine
Author: Laharie, David; Bourreille, Arnaud; Branche, Julien; Allez, Matthieu; Bouhnik, Yoram; Filippi, Jerome; Zerbib, Frank; Savoye, Guillaume; Vuitton, Lucine; Moreau, Jacques; Amiot, Aurelien; Beaugerie, Laurent; Ricart, Elena; Dewit, Olivier; Lopez-Sanroman, Antonio; Fumery, Mathurin; Carbonnel, Franck; Buisson, Anthony; Coffin, Benoit; Roblin, Xavier; van Assche, Gert; Esteve, Maria; Färkkilä, Martti; Gisbert, Javier P.; Marteau, Philippe; Nahon, Stephane; de Vos, Martine; Peyrin-Biroulet, Laurent; Mary, Jean-Yves
Contributor: University of Helsinki, Centre of Excellence in Complex Disease Genetics
Date: 2021-06
Language: eng
Number of pages: 13
Belongs to series: Clinical Gastroenterology and Hepatology
ISSN: 1542-3565
URI: http://hdl.handle.net/10138/332740
Abstract: BACKGROUND/AIMS: Few data on the evolution of endoscopic findings are available in patients with acute severe ulcerative colitis (ASUC). The aim of this study was to describe this evolution in a prospective cohort. METHODS: Patients admitted for a steroid-refractory ASUC and included in a randomized trial comparing infliximab and cyclosporine were eligible if they achieved steroid-free clinical remission at day 98. Flexible sigmoidoscopies were performed at baseline, days 7, 42 and 98. Ulcerative colitis endoscopic index of severity (UCEIS) and its sub-scores - vascular pattern, bleeding and ulceration/erosion - were post-hoc calculated. Global endoscopic remission was defined by a UCEIS of 0, and partial endoscopic remission by any UCEIS sub-score of 0. RESULTS: Among the 55 patients analyzed (29 infliximab and 26 cyclosporine), 49 (83%) had UCEIS >= 6 at baseline at baseline. Partial endoscopic remission rates were higher for bleeding than for vascular pattern and for ulcerations/erosions at day 7 (20% vs. 4% and 5% (n = 55); p CONCLUSION: In steroid-refractory ASUC patients responding to a second-line medical therapy, endoscopic remission process started with bleeding remission and was not achieved in half the patients at day 98 for vascular pattern. Infliximab provided a higher endoscopic remission rate than cyclosporine at day 98.
Subject: ulcerative Colitis
Cyclosporine
Infliximab
Mucosal Healing
UCEIS
MAINTENANCE THERAPY
INDUCTION
INDEX
OUTCOMES
VEDOLIZUMAB
REMISSION
3121 General medicine, internal medicine and other clinical medicine
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