Ciclosporin and infliximab are used as rescue therapies for the treatment of severe steroid-refractory ulcerative colitis. Now, an open-label, head-to-head randomized controlled trial has demonstrated that these drugs are well-tolerated and have equivalent efficacy in inducing short-term clinical response, mucosal healing and decreasing colectomy rates at 3 months.
References
Truelove, S. C. & Jewell, D. P. Intensive intravenous regimen for severe attacks of ulcerative colitis. Lancet 1, 1067–1070 (1974).
Laharie, D. et al. Ciclosporin versus infliximab in patients with severe ulcerative colitis refractory to intravenous steroids: a parallel, open-label randomised controlled trial. Lancet http://dx.doi.org/10.1016/S0140-6736(12)61084-8.
Lichtiger, S. et al. Cyclosporine in severe ulcerative colitis refractory to steroid therapy. N. Engl. J. Med. 330, 1841–1845 (1994).
Actis, G. C. et al. Colectomy rate in steroid-refractory colitis initially responsive to cyclosporin: a long-term retrospective cohort study. BMC Gastroenterol. 7, 13 (2007).
Moskovitz, D. N. et al. Incidence of colectomy during long-term follow-up after cyclosporine-induced remission of severe ulcerative colitis. Clin. Gastroenterol. Hepatol. 4, 760–765 (2006).
Sands, B. E. et al. Infliximab in the treatment of severe, steroid-refractory ulcerative colitis: a pilot study. Inflamm. Bowel Dis. 7, 83–88 (2001).
Probert, C. S. et al. Infliximab in moderately severe glucocorticoid resistant ulcerative colitis: a randomised controlled trial. Gut 52, 998–1002 (2003).
Jarnerot, G. et al. Infliximab as rescue therapy in severe to moderately severe ulcerative colitis: a randomized, placebo-controlled study. Gastroenterology 128, 1805–1811 (2005).
Rutgeerts, P. et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N. Engl. J. Med. 353, 2462–2476 (2005).
Rowe, F. A. et al. Factors predictive of response to cyclosporin treatment for severe, steroid-resistant ulcerative colitis. Am. J. Gastroenterol. 95, 2000–2008 (2000).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Kaur, M., Targan, S. Steroid-refractory ulcerative colitis—ciclosporin or infliximab?. Nat Rev Gastroenterol Hepatol 10, 8–9 (2013). https://doi.org/10.1038/nrgastro.2012.235
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrgastro.2012.235
- Springer Nature Limited